Individual provider Active NPI

Edinah H Lincoln, OTR

  • Occupational Therapist
  • Springfield, IL
National Provider Identifier
1821133075
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-004774 Issued in IL
Practice address
1721 W Governor St
Springfield, IL 62704-1550
Phone
(217) 787-5769
Fax
(217) 787-5769
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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 056-004774 IL Primary

Addresses

Primary practice location

1721 W Governor St
Springfield, IL 62704-1550

Mailing address

1721 W Governor St
Springfield, IL 62704-1550
Phone (217) 787-5769

Other identifiers 2

IdentifierTypeStateIssuer
08432010OtherILBLUE CROSS BLUE SHIELD
735348OtherILHEALTHLINK

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

LicenseStateTypeSpecialty
056-004774ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Specialists, L.L.C. Past Accepting new patients
Sangamon County Pain Center Past Accepting new patients
Integrated Therapy Specialists, L.L.C. Occupational Therapist Past Accepting new patients

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1821133075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 W GOVERNOR ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041550",
            "telephone_number": "217-787-5769",
            "fax_number": "217-787-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W GOVERNOR ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041550",
            "telephone_number": "217-787-5769",
            "fax_number": "217-787-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "EDINAH",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-004774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08432010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "735348",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

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