Jasmine Cornell Decoudres, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

18-01762 Issued in KS

Practice address

2600 Compass Rd
Glenview, IL 60026-8001

Phone

(877) 787-3422

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1578236188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E 10TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671563802",
            "telephone_number": "620-218-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "877-787-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOUDRES",
        "first_name": "JASMINE",
        "middle_name": "CORNELL",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "18-01762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS BOARD OF HEALING ARTS COTA",
            "identifier": "18-01762",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT/COTA",
            "identifier": "453188",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine D. Deamant, MD
• Justice Leslie Dean
• Kathryn M Deangelis, MS,OTR/L
• Marilyn M Deboer, PH.D.
• Sheetal K Decaria, MD
• Carly Elizabeth Deditz
• Joe James Defrank, RPH
• Dehghan-Bernabe, LLC
• Valentina Dehghan-Bernabe, M.D.
• Heather B Dejanovich, LCSW

• Occupational Therapy Assistant in Glenview, IL
• Providers in Glenview, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.