Active NPI
Darcee Lynn Divan, P.T.
- Pediatric Physical Therapist
- Urbana, IL
National Provider Identifier
1306978374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 05009175A
- Practice address
- 810 W Anthony Dr
Urbana, IL 61802-7431 - Phone
- (217) 383-3400
- NPI assigned
- Mar 12, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 05009175A | IN | Primary |
Addresses
Primary practice location
810 W Anthony Dr
Urbana, IL 61802-7431
Mailing address
1505 Holzem CT
Saint Joseph, IL 61873-9484
Other practice location 1
1505 Holzem Ct
Saint Joseph, IL 61873-9484
Phone (217) 418-6761
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200845000 | Other | IN | EARLY INTERVENTION |
| DD57430209P | Other | IL | EARLY INTERVENTION |
| 200848330 | Medicaid | IN |
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 |
|---|---|---|---|
| 05009175A | IN | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River'S Edge Therapy PLLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Saint Joseph, IL
- NPI 1326970765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1306978374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 HOLZEM CT",
"city": "SAINT JOSEPH",
"state": "IL",
"postal_code": "618739484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 W ANTHONY DR",
"city": "URBANA",
"state": "IL",
"postal_code": "618027431",
"telephone_number": "217-383-3400"
}
],
"practiceLocations": [
{
"address_1": "1505 Holzem Ct",
"address_purpose": "LOCATION",
"city": "Saint Joseph",
"state": "IL",
"postal_code": "618739484",
"country_code": "US",
"telephone_number": "217-418-6761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIVAN",
"first_name": "DARCEE",
"middle_name": "LYNN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IN",
"license": "05009175A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EARLY INTERVENTION",
"identifier": "200845000",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EARLY INTERVENTION",
"identifier": "DD57430209P",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200848330",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.