Individual provider Active NPI

Kathryn Anne Oberle, CTRS

  • Recreation Therapist
  • Kalamazoo, MI
National Provider Identifier
1760711311
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
54720 Issued in MI
Practice address
925 Parker Ave
Kalamazoo, MI 49008-3141
Phone
(269) 532-1470
Fax
(269) 532-1472
NPI assigned
Dec 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 54720 MI Primary

Addresses

Primary practice location

925 Parker Ave
Kalamazoo, MI 49008-3141

Mailing address

925 Parker Ave
Kalamazoo, MI 49008-3141
Phone (269) 532-1470

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
54720MIMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1760711311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 PARKER AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083141",
            "telephone_number": "269-532-1470",
            "fax_number": "269-532-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 PARKER AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083141",
            "telephone_number": "269-532-1470",
            "fax_number": "269-532-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERLE",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": "54720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

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