Individual provider Active NPI

Ann M Vinz, OTR, CHT

  • Occupational Therapist
  • Rockford, IL
National Provider Identifier
1780735480
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056012515 Issued in IL
Practice address
324 Roxbury Rd
Rockford, IL 61107-5090
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 056012515 IL Primary

Addresses

Primary practice location

324 Roxbury Rd
Rockford, IL 61107-5090

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Other identifiers 2

IdentifierTypeStateIssuer
JORDANNOtherWIMERCYCARE INSURANCE
1780735480MedicaidWI

Other names 1

  • Ann M Jordan Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120612000570 WI Practitioner - Occupational Therapist in Private Practice 4880858323 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056012515ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 5, 2018 Accepting new patients
Mercy Health System Corporation CurrentSince Apr 9, 2012 Accepting new patients
Orthomidwest, PLLC Occupational Therapist CurrentSince Jul 5, 2018 Accepting new patients
Mercy Health System Corporation Occupational Therapist Current Accepting new patients
Mercy Health System Corporation Occupational Therapist CurrentSince Apr 9, 2012 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

557 N Washington St
Janesville, WI 53548
Phone (608) 754-6000

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: ann.vinz@ro.eclinicaldirectplus.com

Organizations & group practices 5

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1780735480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINZ",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "JORDANN",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780735480",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "JORDAN",
            "middle_name": "M",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.