Active NPI
Kathryn Miller, MOT, OTR/L
- Gerontology Occupational Therapist
- East, IL
National Provider Identifier
1962888735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 056008430
- Practice address
- 3909 5TH Street
East, IL 61244 - Phone
- (309) 737-7289
- NPI assigned
- Aug 4, 2015
- Last updated
- Aug 4, 2015
- 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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 056008430 | IL | Primary |
Addresses
Primary practice location
3909 5TH Street
East, IL 61244
Mailing address
3909 5TH Street
East, IL 61244
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056008430 | IL | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1962888735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3909 5TH STREET",
"city": "EAST",
"state": "IL",
"postal_code": "61244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3909 5TH STREET",
"city": "EAST",
"state": "IL",
"postal_code": "61244",
"telephone_number": "309-737-7289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KATHRYN",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-04",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "IL",
"license": "056008430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.