Individual provider Active NPI

Tori Faulkner

  • Occupational Therapist
  • Springfield, IL
National Provider Identifier
1568073682
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.013777 Issued in IL
Practice address
2508 Saint James Rd
Springfield, IL 62707-9736
Phone
(217) 747-5901
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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 056.013777 IL Primary

Addresses

Primary practice location

2508 Saint James Rd
Springfield, IL 62707-9736

Mailing address

2200 Cloverfield LN
Springfield, IL 62711-9614
Phone (217) 415-0496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210419000917 IN Practitioner - Occupational Therapist in Private Practice 6608284393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Wellness Team LLCGroup PAC ID 5890142145, 41 clinicians

Practice addresses (Care Compare)

1703 W 86TH St
Indianapolis, IN 46260-2002
Phone (866) 360-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.013777ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Apr 1, 2021 Accepting new patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Apr 1, 2021 Accepting new patients
My Wellness Team LLC Occupational Therapist CurrentSince Apr 14, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Apr 20, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Apr 20, 2021 Accepting new patients

Locations

1971 State St
Columbus, IN 47201
Phone (812) 376-0698

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

4411 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 205-8451

10480 Glasswater Ln
Indianapolis, IN 46231
Phone (317) 514-3950

4211 Grimm Rd
Newburgh, IN 47630
Phone (812) 853-9810

10 S 9th St
Ste 4
Noblesville, IN 46060

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1568073682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CLOVERFIELD LN",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627119614",
            "telephone_number": "217-415-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 SAINT JAMES RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627079736",
            "telephone_number": "217-747-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "TORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.