Individual provider Active NPI

Grace Withrow

  • Occupational Therapist
  • Bolingbrook, IL
National Provider Identifier
1346972015
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone
(866) 370-8206
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

790 Remington Blvd
Bolingbrook, IL 60440-4909

Mailing address

1003 Oak Grove CT
Valparaiso, IN 46383-2049

Other identifiers 1

IdentifierTypeStateIssuer
31007741AOtherINOT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711000345 IN Practitioner - Occupational Therapist in Private Practice 4789064502 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Indiana University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Bone and Joint Institute, PCGroup PAC ID 3173500519, 82 clinicians
Bone and Joint Specialists, P.C.Group PAC ID 8820018583, 22 clinicians

Practice addresses (Care Compare)

3691 Willowcreek Rd
Portage, IN 46368-5076
Phone (219) 921-1444

9001 Broadway
Merrillville, IN 46410-7041
Phone (219) 795-3360

Merit-based Incentive Payment System (MIPS)

Final score
81.8 of 100Reported as group
Quality
81.02
Improvement activities
40
Cost
74.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Jul 13, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC Physical Therapist CurrentSince Jul 13, 2022 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC Physical Therapist Current Accepting new patients
Lakeshore Bone & Joint Institute, PC CurrentSince Oct 31, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

601 Gateway Blvd N
Chesterton, IN 46304
Phone (219) 921-1401

500 E 109th Ave
Crown Point, IN 46307

1738 165th St
Ste A
Hammond, IN 46320
Phone (219) 844-1782

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

8455 Broadway
Merrillville, IN 46410
Phone (219) 769-7211

3691 Willowcreek Rd
Portage, IN 46368
Phone (219) 759-4380

3691 Willowcreek Rd
Ste 100
Portage, IN 46368
Phone (219) 759-4380

833 W Lincoln Hwy
Ste 110E
Schererville, IN 46375
Phone (219) 427-0700

71 Silhavy Rd
Ste 121
Valparaiso, IN 46383
Phone (219) 462-0576

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1346972015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 OAK GROVE CT",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHROW",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "31007741A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.