Individual provider Active NPI

Jessica G Hyatt, OTR/L CHT

  • Occupational Therapist
  • Glen Carbon, IL
National Provider Identifier
1457712697
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056011429 Issued in IL
Practice address
4955 S State Route 159 Ste B
Glen Carbon, IL 62034-1907
Phone
(618) 288-4677
NPI assigned
Mar 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056011429 IL Primary

Addresses

Primary practice location

4955 S State Route 159 Ste B
Glen Carbon, IL 62034-1907

Mailing address

15 Apex Dr
Highland, IL 62249-1282
Phone (618) 651-0444

Other practice location 1

800 Devon Ave
Park Ridge, IL 60068-4760
Phone (847) 292-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160322000422 IL Practitioner - Occupational Therapist in Private Practice 0446557219 Reassigns benefits to 1 organization
I20190110000801 MO Practitioner - Occupational Therapist in Private Practice 0446557219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC CurrentSince Aug 14, 2017 Accepting new patients
Apex Physical Therapy, LLC CurrentSince Dec 5, 2018 Accepting new patients
Apex Physical Therapy, LLC CurrentSince Aug 14, 2017 Accepting new patients
Athletico LTD CurrentSince Mar 8, 2016 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Mar 8, 2016 Accepting new patients

Locations

4280 S State Route 159
Ste 3
Glen Carbon, IL 62034
Phone (618) 288-4233

4996 S State Route 159
Ste B
Glen Carbon, IL 62034
Phone (618) 288-4677

4955 S State Route 159
Ste B
Glen Carbon, IL 62034
Phone (618) 288-4677

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

8337 W Lawrence Ave
Norridge, IL 60706
Phone (708) 583-9000

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

800 W Devon Ave
Park Ridge, IL 60068
Phone (847) 292-4710

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

884 Woods Mill Rd
Ste 200
Ballwin, MO 63011
Phone (636) 238-4910

13732 Olive Blvd
Chesterfield, MO 63017
Phone (314) 786-5643

4500 Telegraph Rd
Ste 204
Saint Louis, MO 63129
Phone (314) 487-1204

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1457712697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S STATE ROUTE 159 STE B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341907",
            "telephone_number": "618-288-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Devon Ave",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600684760",
            "country_code": "US",
            "telephone_number": "847-292-4710",
            "fax_number": "847-292-4903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYATT",
        "first_name": "JESSICA",
        "middle_name": "G",
        "credential": "OTR/L CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.