Individual provider Active NPI

Rachel Beth Spaide, MS, OTR/L

  • Occupational Therapist
  • Decatur, IL
National Provider Identifier
1780948547
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056003226 Issued in IL
Practice address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone
(217) 464-2981
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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 056003226 IL Primary

Addresses

Primary practice location

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Mailing address

14 Southbrooke PL
Mt Zion, IL 62549-9708
Phone (217) 864-1359

Other names 1

  • Miss Rachel Beth Smith Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056003226ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1780948547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SOUTHBROOKE PL",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625499708",
            "telephone_number": "217-864-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIDE",
        "first_name": "RACHEL",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "SMITH",
            "middle_name": "BETH",
            "prefix": "MISS",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.