Jennifer Marie Riedle, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.002570 Issued in IL

Practice address

412 1750TH Ave
Mount Pulaski, IL 62548-6641

Phone

(217) 871-5302

NPI assigned

Jul 16, 2014

Last updated

Jul 16, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1073920658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 1750TH AVE",
            "city": "MT. PULASKI",
            "state": "IL",
            "postal_code": "62548",
            "telephone_number": "217-871-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 1750TH AVE",
            "city": "MOUNT PULASKI",
            "state": "IL",
            "postal_code": "625486641",
            "telephone_number": "217-871-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDLE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.002570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Morrow, COTA/L
• Mount Pulaski Community Unit District No 23
• Diana Kay Murphy, LPC
• Oak Counseling PLLC
• Kelsey Oglesby, LCPC
• Sprinfield Clinic LLP (Springfield Clinic Mt Pulaski Rural Health)
• Springfield Clinic Mt Pulaski Lab
• Sarah Ann Tierney, LPC
• Jill Usherwood

• Occupational Therapy Assistant in Mount Pulaski, IL
• Providers in Mount Pulaski, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.