Individual provider Active NPI

Jesse Webb, OTR

  • Occupational Therapist
  • Mount Vernon, IL
National Provider Identifier
1528356557
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056008753 Issued in IL
Practice address
606 E Il Highway 15
Mount Vernon, IL 62864-5072
Phone
(618) 242-1800
NPI assigned
Jul 12, 2011
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 056008753 IL Primary

Addresses

Primary practice location

606 E Il Highway 15
Mount Vernon, IL 62864-5072

Mailing address

16714 Camp Hope Rd
Ewing, IL 62836-1148
Phone (618) 899-0104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118000519 IL Practitioner - Occupational Therapist in Private Practice 8325490097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Dec 5, 2023 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Dec 5, 2023 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1528356557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16714 CAMP HOPE RD",
            "city": "EWING",
            "state": "IL",
            "postal_code": "628361148",
            "telephone_number": "618-899-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 E IL HIGHWAY 15",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645072",
            "telephone_number": "618-242-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "JESSE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.