Megan McClellan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160006504 Issued in IL

Practice address

201 Lafayette Ave
Mattoon, IL 61938-4409

Phone

(217) 235-5449

NPI assigned

Mar 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1205397973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 COUNTY ROAD 700 N",
            "city": "TOLEDO",
            "state": "IL",
            "postal_code": "624683309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAFAYETTE AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384409",
            "telephone_number": "217-235-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "MEGAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160006504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattoon Manor, LLC
• Mattoon Vision Associates
• Nicole Maus, CRNA
• Tatiana K Mauzy, MOT,OTR/L
• Cara McCall, B.A.
• Morgan McClellan
• Alexandra Christine McCollum, PA-C
• Renee Erica McCray, MHP, BS
• Andrew McDevitt, APRN
• Ashley McDonald, BA

• Physical Therapy Assistant in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.