Active NPI
Chad Bowcott
- Occupational Therapist
- Bloomington, IL
National Provider Identifier
1205081825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056004599
- Practice address
- 135 N Williamsburg Dr
Bloomington, IL 61704-3528 - Phone
- (309) 661-8823
- Fax
- (309) 661-8801
- NPI assigned
- Nov 24, 2008
- Sex
- Male
- 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 | 056004599 | IL | Primary |
Addresses
Primary practice location
135 N Williamsburg Dr
Bloomington, IL 61704-3528
Mailing address
PO Box 5387
Bloomington, IL 61702-5387
Phone (309) 661-8823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056004599 | Other | IL | LICENSE |
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 |
|---|---|---|---|
| 056004599 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1205081825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5387",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617025387",
"telephone_number": "309-661-8823",
"fax_number": "309-661-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 N WILLIAMSBURG DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043528",
"telephone_number": "309-661-8823",
"fax_number": "309-661-8801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWCOTT",
"first_name": "CHAD",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-24",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056004599",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "056004599",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.