Active NPI
Danielle Baltierra
- Occupational Therapist
- Champaign, IL
National Provider Identifier
1831521905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056003081
- Practice address
- 1915 S Mattis Ave
Champaign, IL 61821-5919 - Phone
- (217) 352-0516
- NPI assigned
- Jul 31, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056003081 | IL | Primary |
Addresses
Primary practice location
1915 S Mattis Ave
Champaign, IL 61821-5919
Mailing address
1915 S Mattis Ave
Champaign, IL 61821-5919
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 |
|---|---|---|---|
| 056003081 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1831521905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 S MATTIS AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618215919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 S MATTIS AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618215919",
"telephone_number": "217-352-0516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALTIERRA",
"first_name": "DANIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056003081",
"primary": true
}
],
"identifiers": [],
"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 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.