Individual provider Active NPI

Angela Michelle Decker Boyd, OT

  • Occupational Therapist
  • Springfield, IL
National Provider Identifier
1114294485
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056010783 Issued in IL
Practice address
3401 Hedley Rd
Springfield, IL 62711-6421
Phone
(217) 600-9620
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056010783 IL Primary

Addresses

Primary practice location

3401 Hedley Rd
Springfield, IL 62711-6421

Mailing address

212 S Prairie St
Raymond, IL 62560-4938
Phone (217) 600-9620

Other names 1

  • Angela Michelle Decker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909002398 IL Practitioner - Occupational Therapist in Private Practice 5890297642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056010783ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Occupational Therapist CurrentSince Aug 20, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Aug 20, 2025 Accepting new patients
Toddlers Choice Inc. Occupational Therapist Past Accepting new patients
Toddlers Choice Inc. Occupational Therapist Past Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1114294485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S PRAIRIE ST",
            "city": "RAYMOND",
            "state": "IL",
            "postal_code": "625604938",
            "telephone_number": "217-600-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116421",
            "telephone_number": "217-600-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE DECKER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DECKER",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.