Individual provider Active NPI

Page M McIntyre Harris

  • Feeding, Eating & Swallowing Occupational Therapy Assistant
  • Champaign, IL
National Provider Identifier
1669357323
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Feeding, Eating & Swallowing Occupational Therapy AssistantTaxonomy code 224ZF0002X
License
056.009757 Issued in IL
Practice address
201 W Springfield Ave Ste 702
Champaign, IL 61820-4845
Phone
(502) 418-3405
NPI assigned
Aug 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Feeding, Eating & Swallowing Occupational Therapy Assistant 224ZF0002X 056.009757 IL Primary

Addresses

Primary practice location

201 W Springfield Ave Ste 702
Champaign, IL 61820-4845

Mailing address

613 Hessel Blvd
Champaign, IL 61820-6328
Phone (502) 418-3405

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056.009757ILMDFeeding, Eating & Swallowing Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1669357323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 HESSEL BLVD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206328",
            "telephone_number": "502-418-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE STE 702",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204845",
            "telephone_number": "502-418-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PAGE",
        "middle_name": "M MCINTYRE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": "IL",
            "license": "056.009757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.