Individual provider Active NPI

Arvin Quicho

  • Occupational Therapist
  • Decatur, IL
National Provider Identifier
1689132342
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.012787 Issued in IL
Practice address
3911 E Camelot Cir Apt 102
Decatur, IL 62526-6917
Phone
(937) 750-7504
NPI assigned
Mar 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.012787 IL Primary

Addresses

Primary practice location

3911 E Camelot Cir Apt 102
Decatur, IL 62526-6917

Mailing address

3911 E Camelot Cir Apt 102
Decatur, IL 62526-6917
Phone (937) 750-7504

Other practice location 1

3911 E Camelot Cir Apt 102
Decatur, IL 62526-6917
Phone (937) 750-7504

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
056.012787ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1689132342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 E CAMELOT CIR APT 102",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266917",
            "telephone_number": "937-750-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 E CAMELOT CIR APT 102",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266917",
            "telephone_number": "937-750-7504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3911 E Camelot Cir Apt 102",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625266917",
            "country_code": "US",
            "telephone_number": "937-750-7504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUICHO",
        "first_name": "ARVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.