Individual provider Active NPI

Jeffrey Shawn Owens, OTR/L

  • Occupational Therapist
  • Harrisburg, IL
National Provider Identifier
1730415621
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056008792 Issued in IL
Practice address
303 S Commercial St Ste 10
Harrisburg, IL 62946-2125
Phone
(618) 252-5555
Fax
(618) 252-2279
NPI assigned
Oct 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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 056008792 IL Primary

Addresses

Primary practice location

303 S Commercial St Ste 10
Harrisburg, IL 62946-2125

Mailing address

303 S Commercial St Ste 10
Harrisburg, IL 62946-2125
Phone (618) 252-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100423000017 IL Practitioner - Occupational Therapist in Private Practice 1052448057 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056008792ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC CurrentSince Jul 3, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Jul 3, 2023 Accepting new patients
Occupational Performance and Rehab, PC Occupational Therapist CurrentSince Feb 4, 2013 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Jul 3, 2023 Accepting new patients
Empowerme Wellness Kansas City, LLC Occupational Therapist CurrentSince Jul 3, 2023 Accepting new patients
Integrated Health of Southern Illinois, LTD. Past Accepting new patients
Performance Chiropractic of Southern Illinois LLC PastSince Feb 4, 2013 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

3905 W Ernestine Dr
#B
Marion, IL 62959
Phone (618) 993-6237

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 7

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": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1730415621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S COMMERCIAL ST STE 10",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462125",
            "telephone_number": "618-252-5555",
            "fax_number": "618-252-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S COMMERCIAL ST STE 10",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462125",
            "telephone_number": "618-252-5555",
            "fax_number": "618-252-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JEFFREY",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.