NPIMap

Individual provider Active NPI

Karen Davis

  • Occupational Therapist
  • Quincy, IL
National Provider Identifier
1114393097
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056002292 Issued in IL
Practice address
3032 Broadway St
Quincy, IL 62301-3708
Phone
(217) 222-6800
Fax
(217) 222-0037
NPI assigned
Aug 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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 056002292 IL Primary

Addresses

Primary practice location

3032 Broadway St
Quincy, IL 62301-3708

Mailing address

3032 Broadway St
Quincy, IL 62301-3708
Phone (217) 222-6800

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
056002292ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physical Therapy & Sports Medicine of Adams County LLC Past Accepting new patients
Advance Physical Therapy & Sports Medicine LLC Past Accepting new patients

Organizations & group practices 2

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": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1114393097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013708",
            "telephone_number": "217-222-6800",
            "fax_number": "217-222-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013708",
            "telephone_number": "217-222-6800",
            "fax_number": "217-222-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056002292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.