Active NPI
Kate Edgar
- Occupational Therapy Assistant
- Belleville, IL
National Provider Identifier
1093564924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057003537
- Practice address
- 2810 Frank Scott Pkwy W Ste 824
Belleville, IL 62223-5007 - Phone
- (618) 234-9705
- NPI assigned
- May 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 057003537 | IL | Primary |
Addresses
Primary practice location
2810 Frank Scott Pkwy W Ste 824
Belleville, IL 62223-5007
Mailing address
520 Burroughs Ave
Collinsville, IL 62234-3513
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 |
|---|---|---|---|
| 057003537 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1093564924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 BURROUGHS AVE",
"city": "COLLINSVILLE",
"state": "IL",
"postal_code": "622343513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 FRANK SCOTT PKWY W STE 824",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235007",
"telephone_number": "618-234-9705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGAR",
"first_name": "KATE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-14",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057003537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.