Active NPI
Kathryn Elizabeth Richardson, OTRL
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1447463575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 56007498
- Practice address
- 1030 N Clark St
Suite 647
Chicago, IL 60610-5467 - Phone
- (312) 238-7893
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 56007498 | IL | Primary |
Addresses
Primary practice location
1030 N Clark St
Suite 647
Chicago, IL 60610-5467
Mailing address
2930 N Pine Grove Ave
#312
Chicago, IL 60657-5771
Phone (773) 549-2961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220705002880 | AK | Practitioner - Occupational Therapist in Private Practice | 9537549787 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Outreach Center for Understanding Special Needs Inc
Practice addresses (Care Compare)
16635 Centerfield Dr
Suite 103
Eagle River, AK 99577-7745
Phone (907) 694-6002
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56007498 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Outreach Center for Understanding Special Needs Inc | Current | Accepting new patients |
Locations
16635 Centerfield Dr
Ste 103
Eagle River, AK 99577
Phone (907) 694-6002
Organizations & group practices 1
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.
-
- Social Worker
- Eagle River, AK
- NPI 1376620179
AK
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447463575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2930 N PINE GROVE AVE",
"address_2": "#312",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575771",
"telephone_number": "773-549-2961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 N CLARK ST",
"address_2": "SUITE 647",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606105467",
"telephone_number": "312-238-7893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KATHRYN",
"middle_name": "ELIZABETH",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "56007498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.