Individual provider Active NPI

Rebekah Miler-Lyles, COTA/L

  • Occupational Therapy Assistant
  • Wood River, IL
National Provider Identifier
1245893957
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
553 Prospect St
Wood River, IL 62095-1752
Phone
(618) 419-5516
NPI assigned
Apr 18, 2019
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X Primary

Addresses

Primary practice location

553 Prospect St
Wood River, IL 62095-1752

Mailing address

553 Prospect St
Wood River, IL 62095-1752
Phone (618) 419-5516

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

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1245893957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 PROSPECT ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951752",
            "telephone_number": "618-419-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 PROSPECT ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951752",
            "telephone_number": "618-419-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILER-LYLES",
        "first_name": "REBEKAH",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood River, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.