Individual provider Active NPI

Krista Brunner, MS, OTR/L

  • Occupational Therapist
  • Canandaigua, NY
National Provider Identifier
1477889251
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015834-1 Issued in NY
Practice address
63 Wood St
Canandaigua, NY 14424-1817
Phone
(607) 857-5625
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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 015834-1 NY Primary

Addresses

Primary practice location

63 Wood St
Canandaigua, NY 14424-1817

Mailing address

63 Wood St
Canandaigua, NY 14424-1817

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015834-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1477889251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 WOOD ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 WOOD ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241817",
            "telephone_number": "607-857-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "KRISTA",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015834-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.