Brooke Dirks, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056010662 Issued in IL

Practice address

1000 Health Center Dr
Mattoon, IL 61938-9253

Phone

(217) 258-2530

Fax

(217) 258-4176

NPI assigned

Jun 29, 2016

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

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1386095594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2530",
            "fax_number": "217-258-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2530",
            "fax_number": "217-258-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKS",
        "first_name": "BROOKE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.