Individual provider Active NPI

Christian Halterman, OT

  • Occupational Therapist
  • Dyersburg, TN
National Provider Identifier
1730955832
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7837 Issued in TN
Practice address
1700 Woodlawn Ave
Dyersburg, TN 38024-2028
Phone
(731) 286-1115
Fax
(731) 286-0998
NPI assigned
Nov 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 7837 TN Primary

Addresses

Primary practice location

1700 Woodlawn Ave
Dyersburg, TN 38024-2028

Mailing address

257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 660-8781

Other practice location 1

300 Climer Loop N
Alamo, TN 38001-6473
Phone (731) 696-3095

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
7837TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Madison County General Hospital Past Accepting new patients
Lift Therapy, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1730955832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BANCORP SOUTH PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057582",
            "telephone_number": "731-660-8781",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WOODLAWN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242028",
            "telephone_number": "731-286-1115",
            "fax_number": "731-286-0998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Climer Loop N",
            "address_purpose": "LOCATION",
            "city": "Alamo",
            "state": "TN",
            "postal_code": "380016473",
            "country_code": "US",
            "telephone_number": "731-696-3095",
            "fax_number": "731-696-3096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALTERMAN",
        "first_name": "CHRISTIAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "7837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.