Tina Elizabeth Greenland, O.T.R./L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056003949 Issued in IL

Practice address

704 Slippery Rock Dr
Edwardsville, IL 62025-2695

Phone

(618) 692-4808

NPI assigned

Jan 26, 2009

Last updated

Jan 28, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1750529996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 SLIPPERY ROCK DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252695",
            "telephone_number": "618-692-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 SLIPPERY ROCK DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252695",
            "telephone_number": "618-692-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLAND",
        "first_name": "TINA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "O.T.R./L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.