Individual provider Active NPI

Brittne Hall, COTA/L

  • Occupational Therapy Assistant
  • Edwardsville, IL
National Provider Identifier
1831576503
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.004240 Issued in IL
Practice address
401 Saint Marys Dr
Edwardsville, IL 62025-4276
Phone
(618) 692-1330
NPI assigned
May 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.004240 IL Primary

Addresses

Primary practice location

401 Saint Marys Dr
Edwardsville, IL 62025-4276

Mailing address

110 N Oak St
Cottage Hills, IL 62018-1508
Phone (618) 978-6432

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

LicenseStateTypeSpecialty
057.004240ILMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JDV Physical Therapy LLC Current Accepting new patients
Imove Telept, LLC Current Accepting new patients
Booher Health LLC Current 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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1831576503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N OAK ST",
            "city": "COTTAGE HILLS",
            "state": "IL",
            "postal_code": "620181508",
            "telephone_number": "618-978-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SAINT MARYS DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620254276",
            "telephone_number": "618-692-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRITTNE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.004240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.