Active NPI
Christine Ursel Bothun, OTR
- Occupational Therapist
- Winona, MN
National Provider Identifier
1427494160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3791-26
- Practice address
- 403 E Lake Blvd
Winona, MN 55987-5316 - Phone
- (507) 429-7249
- NPI assigned
- May 21, 2013
- Last updated
- May 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3791-26 | WI | Primary |
Addresses
Primary practice location
403 E Lake Blvd
Winona, MN 55987-5316
Mailing address
403 E Lake Blvd
Winona, MN 55987-5316
Phone (507) 429-7249
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3791-26 | Other | WI | OCCUPATIONAL THERAPY WISCONSIN LICENSE- |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3791-26 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1427494160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 E LAKE BLVD",
"city": "WINONA",
"state": "MN",
"postal_code": "559875316",
"telephone_number": "507-429-7249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E LAKE BLVD",
"city": "WINONA",
"state": "MN",
"postal_code": "559875316",
"telephone_number": "507-429-7249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTHUN",
"first_name": "CHRISTINE",
"middle_name": "URSEL",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-21",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3791-26",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY WISCONSIN LICENSE-",
"identifier": "3791-26",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.