KRIS BERNARDIN III (NPI# 1396992723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396992723 |
| Entity Type | Individual |
| Full Name | KRIS BERNARDIN III |
| Practice Address |
1790 S Fairview Ave Decatur IL 62521-4010 |
| Practice Telephone | 2174292551 |
| Mailing Telephone | 2174292551 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 057.002923 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1790 S FAIRVIEW AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-4010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083630487 | Fair Havens Christian Home, Inc. | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2006-07-15 |
| 1720638521 | Fair Havens Senior Living LLC | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2019-09-13 |
| 1376806836 | Gregory Eugene Hamilton Jr. | Physical Therapist | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2012-06-20 |
| 1154637072 | Michael Warner | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2010-08-30 |
| 1528219938 | Fair Havens Christian Home, Inc. | Durable Medical Equipment & Medical Supplies | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-10-03 |
| 1659520104 | Cathy J Solomon | Physical Therapist | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-09-09 |
| 1083862478 | Michelle Lynn Dehaai Fletcher | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-28 |
| 1942458351 | Don Eugene Sprague | Physical Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-28 |
| 1013164029 | Tracy Marie Daniels | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003464413 | Alliah M Iqbal | Occupational Therapy Assistant | 2390 S Lost Bridge Rd, Decatur, IL 62521-4653 | 2019-08-28 |
| 1972061901 | Carol Jean Zilz | Occupational Therapy Assistant | 4825 Evergreen Ct, Decatur, IL 62521-8774 | 2019-03-08 |
| 1992277271 | Mark Anthony Bajkowsky | Occupational Therapy Assistant | 1555 W Business 380, Decatur, TX 76234-3216 | 2018-12-26 |
| 1376015750 | Kailey N Herter | Occupational Therapy Assistant | 7945 Bentonville Rd, Decatur, IL 62521-9512 | 2018-12-21 |
| 1356855241 | Shamia D. James | Occupational Therapy Assistant | 4153 Flat Shoals Pkwy # C300, Decatur, GA 30034-4106 | 2017-11-30 |
| 1568992238 | Ann Marie Barnes | Occupational Therapy Assistant | 341 Winn Way Apt 203, Decatur, GA 30030-2107 | 2017-06-15 |
| 1154850303 | Siran Eller | Occupational Therapy Assistant | 4180 Irving Dr, Decatur, IL 62521-4134 | 2017-06-09 |
| 1871907253 | Cheyanne Harris | Occupational Therapy Assistant | 995 N Park Pl, Decatur, IL 62522-1458 | 2014-06-13 |
| 1962814251 | Elizabeth Scott | Occupational Therapy Assistant | 2531 Brentford Pl, Decatur, GA 30032-5622 | 2014-05-21 |
| 1467884254 | Rebecca Ward | Occupational Therapy Assistant | 1897 Longdale Dr, Decatur, GA 30032-5243 | 2013-08-02 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.