Active NPI
Meredith Sanders Waymire, OTR/L
- Occupational Therapist
- Burr Ridge, IL
National Provider Identifier
1821466103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056011463
- Practice address
- 7600 S County Line Rd
Burr Ridge, IL 60527-6962 - Phone
- (630) 388-2663
- NPI assigned
- Sep 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 310416 | OR | |
| Occupational Therapist | 225X00000X | 110913 | TX | |
| Occupational Therapist | 225X00000X | OTT.200636 | LA | |
| Occupational Therapist | 225X00000X | 5722-26 | WI | |
| Occupational Therapist | 225X00000X | 10152 | NC | |
| Occupational Therapist | 225X00000X | 08083 | MD | |
| Occupational Therapist | 225X00000X | 056011463 | IL | Primary |
Addresses
Primary practice location
7600 S County Line Rd
Burr Ridge, IL 60527-6962
Mailing address
3834 N Kenmore Ave # 1
Chicago, IL 60613-2916
Phone (225) 939-5789
Other practice location 1
355 E Erie St
Chicago, IL 60611-3167
Phone (312) 238-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Louisiana State University School of Medicine in New Orleans, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4943 Fairview LN
Skokie, IL 60077-3523
Phone (312) 285-0359
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056011463 | IL | MD | Occupational Therapist |
| OTT.200636 | LA | MD | Occupational Therapist |
| 08083 | MD | MD | Occupational Therapist |
| 310416 | OR | MD | Occupational Therapist |
| 5722-26 | WI | MD | Occupational Therapist |
| 110913 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Selfcare, PLLC | Occupational Therapist | Current | 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 and National Provider Directory roles.
-
- Occupational Therapist
- Chicago, IL
- NPI 1477249886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1821466103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3834 N KENMORE AVE # 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132916",
"telephone_number": "225-939-5789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 S COUNTY LINE RD",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276962",
"telephone_number": "630-388-2663"
}
],
"practiceLocations": [
{
"address_1": "355 E Erie St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606113167",
"country_code": "US",
"telephone_number": "312-238-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAYMIRE",
"first_name": "MEREDITH",
"middle_name": "SANDERS",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-03",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "310416",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "110913",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "LA",
"license": "OTT.200636",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "5722-26",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "10152",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "08083",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056011463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.