Active NPI
Sharon Ann Decelle, PT, LPC
- Physical Therapist
- Urbana, IL
National Provider Identifier
1316163991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070009964
- Practice address
- 309 E Holmes St
Urbana, IL 61801-6731 - Phone
- (217) 403-9938
- Fax
- (217) 403-9938
- NPI assigned
- Apr 18, 2007
- Last updated
- Mar 18, 2019
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.009488 | IL | |
| Physical Therapist | 225100000X | 070009964 | IL | Primary |
Addresses
Primary practice location
309 E Holmes St
Urbana, IL 61801-6731
Mailing address
309 E Holmes St
Urbana, IL 61801-6731
Phone (217) 365-0330
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4117 | Other | IL | HAMP PROVIDER ID |
| 113326 | Other | HEALTHLINK PROV ID | |
| 202 | Other | IL | BLUE CROSS PROV ID |
| 7216 | Other | PERSONALCARE PROV ID |
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 |
|---|---|---|---|
| 178.009488 | IL | MD | Professional Counselor |
| 070009964 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1316163991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E HOLMES ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618016731",
"telephone_number": "217-365-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E HOLMES ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618016731",
"telephone_number": "217-403-9938",
"fax_number": "217-403-9938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECELLE",
"first_name": "SHARON",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "PT, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.009488",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070009964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAMP PROVIDER ID",
"identifier": "4117",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK PROV ID",
"identifier": "113326",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROV ID",
"identifier": "202",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONALCARE PROV ID",
"identifier": "7216",
"state": null
}
],
"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 Mar 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.