Individual provider Active NPI

Christa Wyman-Hundrieser

  • Occupational Therapy Assistant
  • Freeport, IL
National Provider Identifier
1750742565
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.004439 Issued in IL
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

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
080339IAMDOccupational Therapy Assistant
057.004439ILMDOccupational 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.

Verify at the official NPI Registry.