Kristie Ann Haubrich

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.000484 Issued in IL

Practice address

1313 Pratt St
Barry, IL 62312-1365

Phone

(217) 335-2326

NPI assigned

Dec 29, 2020

Last updated

Dec 29, 2020By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1851988554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUMMER CRK",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623058924",
            "telephone_number": "217-257-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PRATT ST",
            "city": "BARRY",
            "state": "IL",
            "postal_code": "623121365",
            "telephone_number": "217-335-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUBRICH",
        "first_name": "KRISTIE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.000484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kh60625",
            "affiliation": "N",
            "address_1": "1313 Pratt St",
            "city": "Barry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623121365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barry Dental Care PLCC
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• Barry Healthcare and Senior Living LLC
• Dianna Michelle Castleberry
• Alyssa Garde, OTR/L
• Ruth A Holman, NP
• Impact Medical Transport
• Ashley Lefringhouse
• Stephen T Liesen, DMD
• Misti Jo McCallister, MS, RDN

• Physical Therapy Assistant in Barry, IL
• Providers in Barry, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.