Individual provider Active NPI

Regina Schlicksup-Johnson, OTR/L

  • Specialist
  • Louisville, KY
National Provider Identifier
1326392325
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
056.009362 Issued in IL
Practice address
680 S. Fourth St.
Louisville, KY 40202
Phone
(217) 337-2377
Fax
(217) 337-4609
NPI assigned
Oct 30, 2012
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 056.009362 IL Primary

Addresses

Primary practice location

680 S. Fourth St.
Louisville, KY 40202

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (217) 337-2377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260128001630 MI Practitioner - Occupational Therapist in Private Practice 0547662918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1418 Quail Run Dr
Savoy, IL 61874-9681

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.009362ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC CurrentSince Jan 21, 2026 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

7515 Secor Rd
Lambertville, MI 48144
Phone (419) 893-9230

Organizations & group practices 2

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1326392325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "217-337-2377",
            "fax_number": "217-337-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 S. FOURTH ST.",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "217-337-2377",
            "fax_number": "217-337-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICKSUP-JOHNSON",
        "first_name": "REGINA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "056.009362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.