Active NPI
Christa Wyman-Hundrieser
- Occupational Therapy Assistant
- Freeport, IL
National Provider Identifier
1750742565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.004439
- Practice address
- 2946 S Walnut Rd
Freeport, IL 61032-9528 - Phone
- (815) 235-6173
- NPI assigned
- Mar 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057.004439 | IL | Primary |
| Occupational Therapy Assistant | 224Z00000X | 080339 | IA |
Addresses
Primary practice location
2946 S Walnut Rd
Freeport, IL 61032-9528
Mailing address
396 S Snipe Hollow Rd
Elizabeth, IL 61028-9450
Phone (815) 543-5992
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
| License | State | Type | Specialty |
|---|---|---|---|
| 080339 | IA | MD | Occupational Therapy Assistant |
| 057.004439 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457395200000",
"number": "1750742565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 S SNIPE HOLLOW RD",
"city": "ELIZABETH",
"state": "IL",
"postal_code": "610289450",
"telephone_number": "815-543-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2946 S WALNUT RD",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610329528",
"telephone_number": "815-235-6173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYMAN-HUNDRIESER",
"first_name": "CHRISTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-08",
"last_updated": "2016-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.004439",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IA",
"license": "080339",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.