Individual provider Active NPI

Cathy L Borst, OTR/L, CHT

  • Occupational Therapist
  • Champaign, IL
National Provider Identifier
1679530836
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-007563 Issued in IL
Practice address
2300 S 1St St
Champaign, IL 61820-7661
Phone
(217) 383-9500
Fax
(217) 383-9721
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01663 IA
Occupational Therapist 225X00000X 056-007563 IL Primary

Addresses

Primary practice location

2300 S 1St St
Champaign, IL 61820-7661

Mailing address

611 W. Park St.
Fapc
Urbana, IL 61801

Other identifiers 3

IdentifierTypeStateIssuer
$$$$$$$$$MedicaidIL
01663OtherIAIOWA OTR/L LICENSE NO.
056-007563OtherILILLINOIS OTR/L LICENSE NO

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

LicenseStateTypeSpecialty
01663IAMDOccupational Therapist
056-007563ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Occupational Therapist Past Accepting new patients
Rock Valley Physical Therapy Center Occupational Therapist PastSince Sep 26, 2008 Accepting new patients

Organizations & group practices 2

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1679530836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 1ST ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207661",
            "telephone_number": "217-383-9500",
            "fax_number": "217-383-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORST",
        "first_name": "CATHY",
        "middle_name": "L",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01663",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-007563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA OTR/L LICENSE NO.",
            "identifier": "01663",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS OTR/L LICENSE NO",
            "identifier": "056-007563",
            "state": "IL"
        }
    ],
    "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 May 19, 2020; 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.