Individual provider Active NPI

Christine R. Graden, OTR/L

  • Pediatric Occupational Therapist
  • Missoula, MT
National Provider Identifier
1538240213
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
944 Issued in MT
Practice address
901 SW Higgins Ave
Missoula, MT 59803-3600
Phone
(406) 360-2068
Fax
(406) 777-5621
NPI assigned
Oct 18, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 944 MT Primary

Addresses

Primary practice location

901 SW Higgins Ave
Missoula, MT 59803-3600

Mailing address

15853 Queen Annes LN
Florence, MT 59833-5940
Phone (406) 360-2068

Other identifiers 3

IdentifierTypeStateIssuer
944OtherMTOCCUPATIONAL THERAPY LISC
3401836MedicaidMT
662570OtherMTMT BLUE CROSS BLUE SHIELD

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
944MTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Hill Therapy Services PC Pediatrics Current Accepting new patients

Locations

800 Kensington Ave
Ste 100
Missoula, MT 59801
Phone (406) 531-1893

901 SW Higgins Ave
Missoula, MT 59803
Phone (406) 240-6185

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1538240213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15853 QUEEN ANNES LN",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598335940",
            "telephone_number": "406-360-2068",
            "fax_number": "406-777-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SW HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598033600",
            "telephone_number": "406-360-2068",
            "fax_number": "406-777-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADEN",
        "first_name": "CHRISTINE",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LISC",
            "identifier": "944",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401836",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT BLUE CROSS BLUE SHIELD",
            "identifier": "662570",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.