Active NPI
Kristin Kathryn Cochran, COTA/L
- Occupational Therapy Assistant
- Peoria Heights, IL
National Provider Identifier
1255110565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 57003267
- Practice address
- 4450 N Prospect Rd Ste C5
Peoria Heights, IL 61616-6578 - Phone
- (309) 363-7594
- NPI assigned
- Sep 26, 2023
- 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 Therapy Assistant | 224Z00000X | 57003267 | IL | Primary |
Addresses
Primary practice location
4450 N Prospect Rd Ste C5
Peoria Heights, IL 61616-6578
Mailing address
10723 N Honeycreek LN
Dunlap, IL 61525-8736
Phone (309) 360-8112
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 |
|---|---|---|---|
| 57003267 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1255110565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10723 N HONEYCREEK LN",
"city": "DUNLAP",
"state": "IL",
"postal_code": "615258736",
"telephone_number": "309-360-8112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 N PROSPECT RD STE C5",
"city": "PEORIA HEIGHTS",
"state": "IL",
"postal_code": "616166578",
"telephone_number": "309-363-7594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COCHRAN",
"first_name": "KRISTIN",
"middle_name": "KATHRYN",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-26",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "57003267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.