Jacilyn C Dye

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.004792 Issued in IL

Practice address

201 Lafayette Ave E
Mattoon, IL 61938-4641

Phone

(217) 235-5449

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacilyn C Campbell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1366025660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "city": "REDMON",
            "state": "IL",
            "postal_code": "619490154",
            "telephone_number": "217-552-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAFAYETTE AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384641",
            "telephone_number": "217-235-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYE",
        "first_name": "JACILYN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.004792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "2175528942",
            "affiliation": "N",
            "endpointDescription": "phone number",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "201 Lafayette Ave E",
            "city": "Mattoon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619384641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACILYN",
            "last_name": "CAMPBELL",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Jo Dukeman, APRN
• Rachelle Dunckel, PT, DPT
• Amber Dust, APRN, CNP
• Thomas Dust, PA-C
• Abigail Duzan, RSA
• Karen Dyer
• Molly Dyer, MS, MSOT, OTR/L
• Chyna Edwards, PA-C
• Delories Edwards
• Cynthia Maria Einhorn, FNP

• Occupational Therapy Assistant in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.