KRISTIN A ROSE (NPI# 1417590506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417590506 |
| Entity Type | Individual |
| Full Name | KRISTIN A ROSE |
| Other Name | KRISTIN A ROSE |
| Credential | DT |
| Practice Address |
1304 W Bradley Ave Champaign IL 61821-2035 |
| Mailing Address |
701 W Church St Apt 1 Champaign IL 61820-3393 |
| Practice Telephone | 2173569176 |
| Practice Fax Number | 2173987137 |
| Mailing Telephone | 2176217129 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 1801952817 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558661447 | Kristin Rose | Psychologist | 1215 Hall Johnson Rd, Colleyville, TX 76034-7810 | 2010-10-26 |
| Street Address |
1304 W BRADLEY AVE |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-2035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801952817 | Developmental Services Center | Day Training, Developmentally Disabled Services | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2006-12-28 |
| 1023512118 | Agnieszka Chrzanowska | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2018-03-22 |
| 1174053946 | Heather Marie Johnson | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2017-06-14 |
| 1750558326 | Ashley Smiley | Counselor | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2008-05-13 |
| 1659545507 | Susan H Gibson | Physical Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2008-04-22 |
| 1346469228 | Judith Ullom | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2007-04-25 |
| 1720207699 | Barry Chapman | Physical Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2007-04-25 |
| 1558580431 | Kristena Rudloff | Counselor | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2007-04-25 |
| 1740409630 | Mary Petre | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2007-04-25 |
| 1548489438 | Sarajane Annin | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2007-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073090502 | Chanece Richard | Developmental Therapist | 800 S Mattis Ave Apt D3, Champaign, IL 61821-4345 | 2018-07-27 |
| 1659747400 | Andrea Marie Gibson | Developmental Therapist | 3912 Turnberry Dr, Champaign, IL 61822-8547 | 2015-08-17 |
| 1619296084 | Adrienne Morrison | Developmental Therapist | 1016 W Green St, Champaign, IL 61821-3937 | 2010-05-25 |
| 1609193291 | Barbara Rader Sebens | Developmental Therapist | 3008 Cherry Hills Dr, Champaign, IL 61822-7591 | 2010-04-22 |
| 1659600674 | Teresa O'connor | Developmental Therapist | 410 Hessel Blvd, Champaign, IL 61820-6418 | 2009-12-22 |
| 1376796631 | Angela Walder | Developmental Therapist | 4006 Tallgrass Dr, Champaign, IL 61822-2033 | 2008-10-30 |
| 1457526444 | Amanda N Herzog | Developmental Therapist | 1007 Wilshire Ct, Champaign, IL 61821-6934 | 2008-04-29 |
| 1720280746 | Nelly Cristina Alcala | Developmental Therapist | 918 Pomona Dr, Champaign, IL 61822-2361 | 2007-06-01 |
| 1023512118 | Agnieszka Chrzanowska | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2018-03-22 |
| 1174053946 | Heather Marie Johnson | Developmental Therapist | 1304 W Bradley Ave, Champaign, IL 61821-2035 | 2017-06-14 |
| Find all providers in CHAMPAIGN | ||||
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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.