Juan F Pardo, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057000919 Issued in IL

Practice address

444 W Harrison Ave
Decatur, IL 62526-4157

Phone

(217) 877-7333

Fax

(217) 872-6723

NPI assigned

Oct 17, 2009

Sex

Male

Sole proprietor

Yes

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": "1255737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255737600000",
    "number": "1447586979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PEBBLE BEACH DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043151",
            "telephone_number": "217-787-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W HARRISON AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264157",
            "telephone_number": "217-877-7333",
            "fax_number": "217-872-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "JUAN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-17",
        "last_updated": "2009-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057000919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamela Danielle Pagel
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• Amrita S Pandit, M.D
• Benjamin R Papke, DPT
• Paradox Decatur Operator LLC
• Abby Park
• Justin David Parker, MD
• Tachauna Parsons, LSW
• Whitney Pascoe
• Elizabeth Pasquariello, RN, MSN/ED

• Occupational Therapy Assistant in Decatur, IL
• Providers in Decatur, 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 Oct 17, 2009; 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.