Individual provider Active NPI

Brigitte Coglianese, COTA

  • Occupational Therapy Assistant
  • Freeport, IL
National Provider Identifier
1770810780
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4613-027 Issued in WI
Practice address
1045 W Stephenson St
Freeport, IL 61032-4864
Phone
(608) 324-2000
NPI assigned
Nov 11, 2009
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4613-027 WI Primary
Occupational Therapy Assistant 224Z00000X 057.002967 IL

Addresses

Primary practice location

1045 W Stephenson St
Freeport, IL 61032-4864

Mailing address

1045 West Stephenson St
Freeport, IL 61032
Phone (815) 599-6748

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
057.002967ILMDOccupational Therapy Assistant
4613-027WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1770810780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 WEST STEPHENSON ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "61032",
            "telephone_number": "815-599-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W STEPHENSON ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324864",
            "telephone_number": "608-324-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGLIANESE",
        "first_name": "BRIGITTE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4613-027",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.002967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.