Individual provider Active NPI

Brenda Rae Questelle, COTA

  • Occupational Therapy Assistant
  • Mount Carmel, IL
National Provider Identifier
1508007303
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057-002212 Issued in IL
Practice address
1320 W 9TH St
Mount Carmel, IL 62863-2905
Phone
(618) 263-4337
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057-002212 IL Primary

Addresses

Primary practice location

1320 W 9TH St
Mount Carmel, IL 62863-2905

Mailing address

1320 W 9TH St
Mount Carmel, IL 62863-2905
Phone (618) 263-4337

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
057-002212ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1508007303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W 9TH ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632905",
            "telephone_number": "618-263-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W 9TH ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632905",
            "telephone_number": "618-263-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESTELLE",
        "first_name": "BRENDA",
        "middle_name": "RAE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057-002212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, IL

Sources for this page

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