Active NPI
Joan M Robertson, OT
- Occupational Therapist
- Washington, IL
National Provider Identifier
1518138577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056001218
- Practice address
- 209 N Cummings LN
Washington, IL 61571-2181 - Phone
- (309) 886-2305
- Fax
- (309) 444-3893
- NPI assigned
- Mar 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056001218 | IL | Primary |
Addresses
Primary practice location
209 N Cummings LN
Washington, IL 61571-2181
Mailing address
209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 886-2305
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00931265 | Other | IL | RR MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056001218 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1518138577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712181",
"telephone_number": "309-886-2305",
"fax_number": "309-444-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712181",
"telephone_number": "309-886-2305",
"fax_number": "309-444-3893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "JOAN",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056001218",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00931265",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.