Active NPI
Crystal Marie Gottschalk, COTA
- Occupational Therapist
- Madison, WA
National Provider Identifier
1508013046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1860-027
- Practice address
- 4325 Nakoma Road
Sunny Hill Health Care Center
Madison, WA 53711 - Phone
- (608) 271-7321
- NPI assigned
- Aug 27, 2008
- Last updated
- Aug 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 1860-027 | WI | Primary |
Addresses
Primary practice location
4325 Nakoma Road
Sunny Hill Health Care Center
Madison, WA 53711
Mailing address
4325 Nakoma Road
Sunny Hill Health Care Center
Madison, WA 53711
Phone (608) 271-7321
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1860-027 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1508013046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4325 NAKOMA ROAD",
"address_2": "SUNNY HILL HEALTH CARE CENTER",
"city": "MADISON",
"state": "WA",
"postal_code": "53711",
"telephone_number": "608-271-7321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4325 NAKOMA ROAD",
"address_2": "SUNNY HILL HEALTH CARE CENTER",
"city": "MADISON",
"state": "WA",
"postal_code": "53711",
"telephone_number": "608-271-7321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTSCHALK",
"first_name": "CRYSTAL",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "1860-027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.