Active NPI
Kerri L Champagne, MS,OTR L
- Occupational Therapist
- Providence, RI
National Provider Identifier
1780694679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00983
- Practice address
- 1000 Eddy Street
Providence, RI 02905 - Phone
- (401) 533-9100
- NPI assigned
- Aug 9, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT00983 | RI | Primary |
Addresses
Primary practice location
1000 Eddy Street
Providence, RI 02905
Mailing address
1000 Eddy Street
Providence, RI 02905
Phone (401) 533-9100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99947 | Other | RI | SS BLUE CROSS |
| 6400144 | Other | RI | SS UHP |
| 9009994 | Medicaid | RI | |
| 2058 | Other | RI | SS NHPRC |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT00983 | RI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meeting Street Center | Past | Accepting new patients | |
| Meeting Street Center | 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.
-
- Hearing and Speech Clinic/Center
- Providence, RI
- NPI 1063534790
-
- Multi-Specialty Clinic/Center
- Providence, RI
- NPI 1154443885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1780694679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 EDDY STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02905",
"telephone_number": "401-533-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EDDY STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02905",
"telephone_number": "401-533-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "KERRI",
"middle_name": "L",
"credential": "MS,OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "RI",
"license": "OT00983",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SS BLUE CROSS",
"identifier": "99947",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SS UHP",
"identifier": "6400144",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9009994",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SS NHPRC",
"identifier": "2058",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.