Individual provider Active NPI

Katrina Williams, OTR/L

  • Occupational Therapist
  • Olney, IL
National Provider Identifier
1801424957
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.011663 Issued in IL
Practice address
800 E Locust St
Olney, IL 62450-2553
Phone
(618) 599-6193
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 056.011663 IL Primary

Addresses

Primary practice location

800 E Locust St
Olney, IL 62450-2553

Mailing address

1079 E Antioch LN
Noble, IL 62868-2225
Phone (618) 599-6193

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Computer Direct Carle Foundation Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201001651 IL Practitioner - Occupational Therapist in Private Practice 5799175055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.011663ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Nov 22, 2021 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Nov 22, 2021 Accepting new patients

Locations

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1801424957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 E ANTIOCH LN",
            "city": "NOBLE",
            "state": "IL",
            "postal_code": "628682225",
            "telephone_number": "618-599-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-599-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATRINA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.011663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Computer",
            "affiliation": "Y",
            "endpointDescription": "Computer, fax, phone, etc.",
            "affiliationName": "Carle Foundation Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "therapy, medical, surgery, etc.",
            "address_1": "800 E Locust St",
            "city": "Olney",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624502553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.