Active NPI
Steven J Jellum, OTR
- Occupational Therapist
- Lititz, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC011917
- Practice address
- 3001 Lititz Pike
Lititz, PA 17543-9414 - Phone
- (800) 367-9899
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 30813 | OR | |
| Occupational Therapist | 225X00000X | 76 | HI | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | OT 12844 | FL | |
| Occupational Therapist | 225X00000X | OC011917 | PA | Primary |
Addresses
Primary practice location
3001 Lititz Pike
Lititz, PA 17543-9414
Mailing address
407 Lake St
Ephrata, PA 17522-2659
Phone (717) 615-2250
Other practice location 1
4247 Wordsworth Way
Venice, FL 34293-5243
Phone (808) 227-5810
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 |
|---|---|---|---|
| 30813 | OR | MD | Occupational Therapist |
| OC011917 | PA | MD | Occupational Therapist |
| OT 12844 | FL | MD | Physical Rehabilitation Occupational Therapist |
| 76 | HI | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cortlyn Therapy, PC | Occupational Therapist | Current | Accepting new patients |
Locations
28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 250-4576
7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817
1215 Hulton Rd
Oakmont, PA 15139
Phone (412) 659-2450
1361 E Boot Rd
West Chester, PA 19380
Phone (484) 653-1200
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1023239472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 LAKE ST",
"city": "EPHRATA",
"state": "PA",
"postal_code": "175222659",
"telephone_number": "717-615-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 LITITZ PIKE",
"city": "LITITZ",
"state": "PA",
"postal_code": "175439414",
"telephone_number": "800-367-9899"
}
],
"practiceLocations": [
{
"address_1": "4247 Wordsworth Way",
"address_purpose": "LOCATION",
"city": "Venice",
"state": "FL",
"postal_code": "342935243",
"country_code": "US",
"telephone_number": "808-227-5810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JELLUM",
"first_name": "STEVEN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "30813",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "76",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "FL",
"license": "OT 12844",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC011917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lititz, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.