Active NPI
Cecelia A Long, OT
- Occupational Therapist
- Quincy, IL
National Provider Identifier
1194076570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056009853
- Practice address
- 804 State St
#5
Quincy, IL 62301-4968 - Phone
- (217) 224-1750
- Fax
- (217) 224-0403
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | 056009853 | IL | Primary |
Addresses
Primary practice location
804 State St
#5
Quincy, IL 62301-4968
Mailing address
804 State St
#5
Quincy, IL 62301-4968
Phone (217) 224-1750
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 |
|---|---|---|---|
| 056009853 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletic and Therapeutic Institute of Bourbonnais, LLC | Occupational Therapist | Past | Accepting new patients |
| Athletic and Therapeutic Institute of Bourbonnais, 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.
-
- Durable Medical Equipment & Medical Supplies
- Columbia, IL
- NPI 1124766696
Occupational Therapist
-
- Physical Therapist
- Bourbonnais, IL
- NPI 1861503542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1194076570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 STATE ST",
"address_2": "#5",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014968",
"telephone_number": "217-224-1750",
"fax_number": "217-224-0403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 STATE ST",
"address_2": "#5",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014968",
"telephone_number": "217-224-1750",
"fax_number": "217-224-0403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "CECELIA",
"middle_name": "A",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-26",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056009853",
"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 Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.