Individual provider Active NPI

Charlene Beth Rieches, PTA

  • Physical Therapy Assistant
  • Danville, IL
National Provider Identifier
1396933990
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
812 N Logan Ave
Danville, IL 61832-3752
Phone
(217) 443-5000
Fax
(217) 443-5634
NPI assigned
Oct 9, 2007
Last updated
Oct 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X IL Primary

Addresses

Primary practice location

812 N Logan Ave
Danville, IL 61832-3752

Mailing address

812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000

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

LicenseStateTypeSpecialty
160.003042ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1396933990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323752",
            "telephone_number": "217-443-5000",
            "fax_number": "217-443-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323752",
            "telephone_number": "217-443-5000",
            "fax_number": "217-443-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIECHES",
        "first_name": "CHARLENE",
        "middle_name": "BETH",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.