Individual provider Active NPI

Steven J Jellum, OTR

  • Occupational Therapist
  • Lititz, PA
National Provider Identifier
1023239472
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC011917 Issued in PA
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

Updated by the provider on Mar 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
30813ORMDOccupational Therapist
OC011917PAMDOccupational Therapist
OT 12844FLMDPhysical Rehabilitation Occupational Therapist
76HIMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Occupational Therapist CurrentSince Jun 7, 2024 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.

Verify at the official NPI Registry.