Individual provider Active NPI

Chrystal Marie Montroy, COTA/L

  • Occupational Therapy Assistant
  • Macomb, IL
National Provider Identifier
1447592886
Registry record updated Mar 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057002566 Issued in IL
Practice address
8 Doctors LN
Macomb, IL 61455-3310
Phone
(309) 833-5555
NPI assigned
Mar 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057002566 IL Primary

Addresses

Primary practice location

8 Doctors LN
Macomb, IL 61455-3310

Mailing address

4851 E 50TH St
Plymouth, IL 62367-2430
Phone (309) 337-4125

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

LicenseStateTypeSpecialty
057002566ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364083200000",
    "number": "1447592886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 E 50TH ST",
            "city": "PLYMOUTH",
            "state": "IL",
            "postal_code": "623672430",
            "telephone_number": "309-337-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOCTORS LN",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553310",
            "telephone_number": "309-833-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTROY",
        "first_name": "CHRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2013-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057002566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.

Verify at the official NPI Registry.