Individual provider Active NPI

Kathryn Elizabeth Richardson, OTRL

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1447463575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
56007498 Issued in IL
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

Updated by the provider on Jul 8, 2007

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 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 IDStateProvider typePAC IDDetails
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 IncGroup PAC ID 2365832425, 2 clinicians

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

LicenseStateTypeSpecialty
56007498ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Outreach Center for Understanding Special Needs Inc CurrentSince Dec 2, 2021 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.

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.

Verify at the official NPI Registry.