Jessica Nicole Kistler, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.012923 Issued in IL

Practice address

480 W Polk Ave
Charleston, IL 61920-2557

Phone

(618) 231-1877

NPI assigned

Feb 20, 2019

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

• Jessica Nicole Baker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1467919910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PINE DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012954",
            "telephone_number": "618-231-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W POLK AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202557",
            "telephone_number": "618-231-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BAKER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa K Kenter, APN
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• Michele Kinder, NP
• Timothy King, RPH, PHARM.D
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• Brian Keith Klepzig, D.C., L. AC.
• Morgan Knisley, OT
• Emily Marie Koester

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.