21St Century Total Wellness

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32000255A Issued in IN

Legal business name

21ST CENTURY TOTAL WELLNESS

Practice address

501 W 84TH Dr Ste 1
Merrillville, IN 46410-7013

Phone

(219) 756-4695

Fax

(219) 793-9629

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edgar D PraterNPI 1083753099

Title

President

Phone

(219) 756-4695

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgar D Prater

  • Occupational Therapy Assistant
  • Merrillville, IN
  • NPI 1083753099
  NPD (past) Authorized official
• Chantel Kelly Anderson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, IN
  • NPI 1235369380
  NPD (past)
• Jill Brogdon, OTR

  • Specialist
  • Demotte, IN
  • NPI 1689701575
  NPD (past)
• Christina Gutierrez, OTR

  • Specialist
  • Demotte, IN
  • NPI 1689701591
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639218910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 84TH DR STE 1",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107013",
            "telephone_number": "219-756-4695",
            "fax_number": "219-793-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 84TH DR STE 1",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107013",
            "telephone_number": "219-756-4695",
            "fax_number": "219-793-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY TOTAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-756-4695"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32000255A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 1St Option Seniors Day Healtcare, Inc
• 2ND Chance Homecare Services, LLC
• 3 Nurses Home Health Care LLC
• 360 Medical Group Indiana P.C.
• 365 Medical Supplies Incorporated
• A & a Dental Center

• Occupational Therapy Assistant in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.