Active NPI
Kelli Lane Rode
- Occupational Therapist
- St Charles, IL
National Provider Identifier
1801103759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.008241
- Practice address
- 964 N 5TH Ave
Building C
St Charles, IL 60174-1204 - Phone
- (630) 484-4142
- NPI assigned
- Sep 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.008241 | IL | Primary |
Addresses
Primary practice location
964 N 5TH Ave
Building C
St Charles, IL 60174-1204
Mailing address
470 Chesterfield LN
North Aurora, IL 60542-9105
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.008241 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1801103759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 CHESTERFIELD LN",
"city": "NORTH AURORA",
"state": "IL",
"postal_code": "605429105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "964 N 5TH AVE",
"address_2": "BUILDING C",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601741204",
"telephone_number": "630-484-4142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODE",
"first_name": "KELLI",
"middle_name": "LANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.008241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.