Active NPI
Samantha Jane Crow, OTR/L
- Occupational Therapist
- Farmington, IL
National Provider Identifier
1245741198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.011814
- Practice address
- 701 S Main St
Farmington, IL 61531-1460 - Phone
- (309) 245-2407
- NPI assigned
- Oct 18, 2017
- Last updated
- Oct 18, 2017
- 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 | 056.011814 | IL | Primary |
Addresses
Primary practice location
701 S Main St
Farmington, IL 61531-1460
Mailing address
7400 N Villa Lake Dr Apt P1
Peoria, IL 61614-8265
Phone (309) 410-7814
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.011814 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508284800000",
"number": "1245741198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 N VILLA LAKE DR APT P1",
"city": "PEORIA",
"state": "IL",
"postal_code": "616148265",
"telephone_number": "309-410-7814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 S MAIN ST",
"city": "FARMINGTON",
"state": "IL",
"postal_code": "615311460",
"telephone_number": "309-245-2407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROW",
"first_name": "SAMANTHA",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-18",
"last_updated": "2017-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.