Individual provider Active NPI

Amy Chappell, OTR

  • Occupational Therapist
  • Fort Wayne, IN
National Provider Identifier
1548640931
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31000314A Issued in IN
Practice address
1717 Maplecrest Rd
Fort Wayne, IN 46815-7656
Phone
(260) 417-4622
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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 31000314A IN Primary

Addresses

Primary practice location

1717 Maplecrest Rd
Fort Wayne, IN 46815-7656

Mailing address

9528 Hartzell Rd
Fort Wayne, IN 46816-9729
Phone (260) 417-4622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210317002726 IN Practitioner - Occupational Therapist in Private Practice 9032526025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Empowerme Rehabilitation Illinois LLCGroup PAC ID 2365718277, 361 clinicians

Practice addresses (Care Compare)

1300 Vale Park Rd
Valparaiso, IN 46383-2722
Phone (219) 786-2123

329 Rainbow Dr
Kokomo, IN 46902-3869
Phone (765) 400-2939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Apr 14, 2021 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Mar 1, 2021 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Mar 1, 2021 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Apr 14, 2021 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3203 E Moores Pike
Bloomington, IN 47401
Phone (812) 269-8220

1941 W US Highway 40
Brazil, IN 47834
Phone (812) 420-2188

7900 Rhode Island St
#1504
Merrillville, IN 46410
Phone (219) 649-0625

5865 Sugar Ln
Plainfield, IN 46168
Phone (317) 680-7999

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1548640931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9528 HARTZELL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468169729",
            "telephone_number": "260-417-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157656",
            "telephone_number": "260-417-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "AMY",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000314A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.