Individual provider Active NPI

Jeff Mocilan, M.S.,P.T.

  • Physical Therapist
  • Energy, IL
National Provider Identifier
1306851167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2501 Fairway Dr
Energy, IL 62933-3567
Phone
(618) 988-9593
NPI assigned
Jul 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

2501 Fairway Dr
Energy, IL 62933-3567

Mailing address

2501 Fairway Dr
Energy, IL 62933-3567
Phone (618) 988-9593

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
070-009735ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Chiropractic of Southern Illinois LLC Past Accepting new patients
Heartland Balance and Hearing Center SC Past Accepting new patients
Spinalaid Center of Illinois SC Past Accepting new patients
Southern Illinois Hospital Services Past Accepting new patients
Occupational Performance and Rehab, PC Physical Therapist PastSince Feb 4, 2013 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306851167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 FAIRWAY DR",
            "city": "ENERGY",
            "state": "IL",
            "postal_code": "629333567",
            "telephone_number": "618-988-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 FAIRWAY DR",
            "city": "ENERGY",
            "state": "IL",
            "postal_code": "629333567",
            "telephone_number": "618-988-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCILAN",
        "first_name": "JEFF",
        "credential": "M.S.,P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Energy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.