Active NPI
Connie Rystrom, OTR/L, CHT
- Hand Occupational Therapist
- Cedar Rapids, IA
National Provider Identifier
1891705273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 00152
- Practice address
- 2750 1St Ave NE
Suite 200
Cedar Rapids, IA 52402-4831 - Phone
- (319) 366-1886
- Fax
- (319) 366-1611
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 00152 | IA | Primary |
Addresses
Primary practice location
2750 1St Ave NE
Suite 200
Cedar Rapids, IA 52402-4831
Mailing address
10101 Hall Rd
Cedar Rapids, IA 52411-7910
Phone (319) 366-1886
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00152 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1891705273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10101 HALL RD",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524117910",
"telephone_number": "319-366-1886",
"fax_number": "319-366-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 1ST AVE NE",
"address_2": "SUITE 200",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524024831",
"telephone_number": "319-366-1886",
"fax_number": "319-366-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYSTROM",
"first_name": "CONNIE",
"credential": "OTR/L, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "IA",
"license": "00152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.