Active NPI
Alicia Devitt
- Occupational Therapist
- Mattoon, IL
National Provider Identifier
1306277884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-006656
- Practice address
- 3516 W Powell LN
Mattoon, IL 61938-2266 - Phone
- (217) 234-6402
- NPI assigned
- Dec 9, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056-006656 | IL | Primary |
| Occupational Therapist | 225X00000X | 583-26 | WI |
Addresses
Primary practice location
3516 W Powell LN
Mattoon, IL 61938-2266
Mailing address
3516 W Powell LN
Mattoon, IL 61938-2266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056-006656 | Medicaid | IL |
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 |
|---|---|---|---|
| 056-006656 | IL | MD | Occupational Therapist |
| 583-26 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386547200000",
"number": "1306277884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3516 W POWELL LN",
"city": "MATTOON",
"state": "IL",
"postal_code": "619382266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3516 W POWELL LN",
"city": "MATTOON",
"state": "IL",
"postal_code": "619382266",
"telephone_number": "217-234-6402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVITT",
"first_name": "ALICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-09",
"last_updated": "2013-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-006656",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "583-26",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "056-006656",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.