Misty Leigh White- King, OCCUPATIONAL THERAPY

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056005570 Issued in IL

Practice address

399 Berlin Rd
New Berlin, IL 62670-7957

Phone

(217) 652-0146

NPI assigned

Nov 7, 2006

Last updated

Jul 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Childrite Development

  • Durable Medical Equipment & Medical Supplies
  • New Berlin, IL
  • NPI 1033401815
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1851460778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 BERLIN RD",
            "city": "NEW BERLIN",
            "state": "IL",
            "postal_code": "626704541",
            "telephone_number": "217-652-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 BERLIN RD",
            "city": "NEW BERLIN",
            "state": "IL",
            "postal_code": "626707957",
            "telephone_number": "217-652-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE- KING",
        "first_name": "MISTY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "056005570",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056005570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "8432032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Hughes
• Jennie Marie Killam
• Linda L Orr, OTR/L
• Physicians Group Associates SC
• Stephanie Snyder, BACHELORS OF SCIENCE

• Occupational Therapist in New Berlin, IL
• Providers in New Berlin, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.