Active NPI
Corissa McCloud
- Occupational Therapy Assistant
- Glenview, IL
National Provider Identifier
1053998674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA002316
- Practice address
- 2600 Compass Rd
Glenview, IL 60026-8001 - Phone
- (877) 787-3430
- NPI assigned
- Mar 28, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA002316 | GA | Primary |
Addresses
Primary practice location
2600 Compass Rd
Glenview, IL 60026-8001
Mailing address
400 Belmont PL SE Unit 2338
Smyrna, GA 30080-2055
Phone (850) 227-6904
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 |
|---|---|---|---|
| OTA002316 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616889600000",
"number": "1053998674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 BELMONT PL SE UNIT 2338",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300802055",
"telephone_number": "850-227-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 COMPASS RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268001",
"telephone_number": "877-787-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLOUD",
"first_name": "CORISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-28",
"last_updated": "2021-03-28",
"certification_date": "2021-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA002316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.