Autumn Gleich, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.009230 Issued in IL

Practice address

7018 Saint Leos Rd
Evansville, IL 62242-1602

Phone

(618) 580-6541

Fax

(888) 388-2143

NPI assigned

Mar 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Brefeld Physical Therapy Services PC

  • Physical Therapist
  • Belleville, IL
  • NPI 1053308015

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1700185337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7018 SAINT LEOS RD",
            "city": "EVANSVILLE",
            "state": "IL",
            "postal_code": "622421602",
            "telephone_number": "618-580-6541",
            "fax_number": "888-388-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7018 SAINT LEOS RD",
            "city": "EVANSVILLE",
            "state": "IL",
            "postal_code": "622421602",
            "telephone_number": "618-580-6541",
            "fax_number": "888-388-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEICH",
        "first_name": "AUTUMN",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.009230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321867871001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Evansville, IL
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.