Active NPI
Callie Ann Feldman
- Occupational Therapy Assistant
- Godfrey, IL
National Provider Identifier
1629457536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.003210
- Practice address
- 1373 D'Adrian Professional Park
Godfrey, IL 62035 - Phone
- (618) 468-8010
- NPI assigned
- May 26, 2015
- Last updated
- May 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 057.003210 | IL | Primary |
Addresses
Primary practice location
1373 D'Adrian Professional Park
Godfrey, IL 62035
Mailing address
1373 D'Adrian Professional Park
Godfrey, IL 62035
Phone (618) 468-8010
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 |
|---|---|---|---|
| 057.003210 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432598400000",
"number": "1629457536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1373 D'ADRIAN PROFESSIONAL PARK",
"city": "GODFREY",
"state": "IL",
"postal_code": "62035",
"telephone_number": "618-468-8010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1373 D'ADRIAN PROFESSIONAL PARK",
"city": "GODFREY",
"state": "IL",
"postal_code": "62035",
"telephone_number": "618-468-8010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELDMAN",
"first_name": "CALLIE",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-26",
"last_updated": "2015-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.003210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Godfrey, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.