Individual provider Active NPI

Makaley M Velazquez, COTA/L

  • Occupational Therapy Assistant
  • Sterling, IL
National Provider Identifier
1154016541
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.005885 Issued in IL
Practice address
105 E 23Rd St
Sterling, IL 61081-1212
Phone
(425) 481-5626
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 098797 IA
Occupational Therapy Assistant 224Z00000X 057.005885 IL Primary

Addresses

Primary practice location

105 E 23Rd St
Sterling, IL 61081-1212

Mailing address

28740 W Thome Rd
Rock Falls, IL 61071-9263
Phone (815) 718-0918

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

LicenseStateTypeSpecialty
098797IAMDOccupational Therapy Assistant
057.005885ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1154016541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28740 W THOME RD",
            "city": "ROCK FALLS",
            "state": "IL",
            "postal_code": "610719263",
            "telephone_number": "815-718-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 23RD ST",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811212",
            "telephone_number": "425-481-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "MAKALEY",
        "middle_name": "M",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IA",
            "license": "098797",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.