Individual provider Active NPI

Karen Wauters

  • Neurorehabilitation Occupational Therapist
  • Summit, NJ
National Provider Identifier
1467067793
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
TR002213 Issued in NJ
Practice address
22 Twombly Dr
Summit, NJ 07901-3027
Phone
(954) 778-7201
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X TR002213 NJ Primary

Addresses

Primary practice location

22 Twombly Dr
Summit, NJ 07901-3027

Mailing address

22 Twombly Dr
Summit, NJ 07901-3027
Phone (954) 778-7201

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL macbook

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
TR002213NJMDNeurorehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1467067793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TWOMBLY DR",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013027",
            "telephone_number": "954-778-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TWOMBLY DR",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013027",
            "telephone_number": "954-778-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUTERS",
        "first_name": "KAREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NJ",
            "license": "TR002213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "macbook",
            "affiliation": "N",
            "address_1": "22 Twombly Dr",
            "city": "Summit",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "079013027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.