Individual provider Active NPI

Joel Hartlan Desotelle, MS OTR/L

  • Pediatric Occupational Therapist
  • Chambersburg, PA
National Provider Identifier
1669570883
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OC008778 Issued in PA
Practice address
111 Chambers Hill Dr Ste 101
Chambersburg, PA 17201-7304
Phone
(717) 709-7997
Fax
(717) 261-4725
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 04495 MD
Neurorehabilitation Occupational Therapist 225XN1300X OC008778 PA
Physical Rehabilitation Occupational Therapist 225XP0019X OC008778 PA
Pediatric Occupational Therapist 225XP0200X OC008778 PA Primary

Addresses

Primary practice location

111 Chambers Hill Dr Ste 101
Chambersburg, PA 17201-7304

Mailing address

111 Chambers Hill Dr Ste 200
Chambersburg, PA 17201-7304
Phone (717) 709-7922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150128000456 PA Practitioner - Occupational Therapist in Private Practice 7517969298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rural Health CenterGroup PAC ID 5496663312, 44 clinicians

Practice addresses (Care Compare)

111 Chambers Hill Dr
Chambersburg, PA 17201-7304

820 5TH Ave
Chambersburg, PA 17201-4219
Phone (717) 709-7999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OC008778PAMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Rural Health Center CurrentSince Dec 21, 2021 Accepting new patients
Keystone Rural Health Center Current Accepting new patients
Amber Hill Physical Therapy, Inc. Occupational Therapist PastSince Feb 8, 1990 Accepting new patients

Locations

111 Chambers Hill Dr
Ste 200
Chambersburg, PA 17201
Phone (717) 709-7900

111 Chambers Hill Dr
Ste 101
Chambersburg, PA 17201
Phone (717) 709-7997

22 St Paul Dr
Ste 200
Chambersburg, PA 17201
Phone 71770979227985

820 5th Ave
Chambersburg, PA 17201
Phone (717) 263-4313

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1669570883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 200",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7922",
            "fax_number": "717-263-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 101",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7997",
            "fax_number": "717-261-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOTELLE",
        "first_name": "JOEL",
        "middle_name": "HARTLAN",
        "name_prefix": "Mr.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "04495",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "PA",
            "license": "OC008778",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "PA",
            "license": "OC008778",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PA",
            "license": "OC008778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.