Individual provider Active NPI

Celeste M Gawanda

  • Occupational Therapy Assistant
  • Wichita, KS
National Provider Identifier
1821450867
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
T-04450 Issued in KS
Practice address
3500 N Rock Rd
Buidling 2200, Suite 101
Wichita, KS 67226-1341
Phone
(316) 440-3316
Fax
(888) 965-6885
NPI assigned
Mar 28, 2016
Last updated
May 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X T-04450 KS Primary

Addresses

Primary practice location

3500 N Rock Rd
Buidling 2200, Suite 101
Wichita, KS 67226-1341

Mailing address

11623 Arbor St
Omaha, NE 68144-2981

Other names 1

  • Celeste M Burger Former name

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
T-04450KSMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sprout Pediatric Occupational Therapy, LLC Past Accepting new patients

Organizations & group practices 1

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1821450867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11623 ARBOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N ROCK RD",
            "address_2": "BUIDLING 2200, SUITE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261341",
            "telephone_number": "316-440-3316",
            "fax_number": "888-965-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWANDA",
        "first_name": "CELESTE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "T-04450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CELESTE",
            "last_name": "BURGER",
            "middle_name": "M",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.