Individual provider Active NPI

Christine Chmielak, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1740474881
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12510 Issued in CA
Practice address
9520 Padgett St
Suite 104
San Diego, CA 92126-4445
Phone
(858) 866-8133
Fax
(858) 999-2002
NPI assigned
Aug 31, 2007
Last updated
Sep 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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 12510 CA Primary

Addresses

Primary practice location

9520 Padgett St
Suite 104
San Diego, CA 92126-4445

Mailing address

5067 Niagara Ave
Apartment 8
San Diego, CA 92107-3077
Phone (858) 866-8133

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab at Your Place, LLC Occupational Therapist Past Accepting new patients
Blast Off Children's Therapy Services, 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, 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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1740474881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5067 NIAGARA AVE",
            "address_2": "APARTMENT 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073077",
            "telephone_number": "858-866-8133",
            "fax_number": "858-999-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 PADGETT ST",
            "address_2": "SUITE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264445",
            "telephone_number": "858-866-8133",
            "fax_number": "858-999-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMIELAK",
        "first_name": "CHRISTINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.