Active NPI
Debra Lynn Bliss, OTR-L
- Pediatric Occupational Therapist
- Champaign, IL
National Provider Identifier
1821159591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Practice address
- 510 S Staley Rd Ste a
Champaign, IL 61822-9234 - Phone
- (217) 493-4175
- Fax
- (217) 351-6486
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | IL | Primary |
Addresses
Primary practice location
510 S Staley Rd Ste a
Champaign, IL 61822-9234
Mailing address
1 Welsh Cobb Cir
White Heath, IL 61884-9702
Phone (217) 687-4175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07432001 | Other | IL | BLUE CROSS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.002983 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821159591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WELSH COBB CIR",
"city": "WHITE HEATH",
"state": "IL",
"postal_code": "618849702",
"telephone_number": "217-687-4175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S STALEY RD STE A",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618229234",
"telephone_number": "217-493-4175",
"fax_number": "217-351-6486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLISS",
"first_name": "DEBRA",
"middle_name": "LYNN",
"credential": "OTR-L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "07432001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.