Individual provider Active NPI

Karen Lynn Dierolf, OTR, CHT

  • Occupational Therapist
  • Waco, TX
National Provider Identifier
1639290927
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106194 Issued in TX
Practice address
7003 Woodway Dr
Suite 302
Waco, TX 76712-6170
Phone
(254) 776-7864
Fax
(254) 776-0775
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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 106194 TX Primary

Addresses

Primary practice location

7003 Woodway Dr
Suite 302
Waco, TX 76712-6170

Mailing address

3757 Ross Rd.
Waco, TX 76705-5712
Phone (210) 241-7410

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
106194TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1639290927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 ROSS RD.",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767055712",
            "telephone_number": "210-241-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 WOODWAY DR",
            "address_2": "SUITE 302",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126170",
            "telephone_number": "254-776-7864",
            "fax_number": "254-776-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEROLF",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "106194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.