Individual provider Active NPI

Pamela Mack-Rainey

  • Occupational Therapist
  • Swansea, IL
National Provider Identifier
1841627403
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056003214 Issued in IL
Practice address
1533 William LN
Swansea, IL 62226-2434
Phone
(630) 853-0139
NPI assigned
Sep 27, 2013
Last updated
Sep 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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 056003214 IL Primary

Addresses

Primary practice location

1533 William LN
Swansea, IL 62226-2434

Mailing address

1533 William LN
Swansea, IL 62226-2434
Phone (630) 853-0139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622000088 IL Practitioner - Occupational Therapist in Private Practice 1456642495 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Jun 16, 2016 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Jun 16, 2016 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1841627403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 WILLIAM LN",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262434",
            "telephone_number": "630-853-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 WILLIAM LN",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262434",
            "telephone_number": "630-853-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK-RAINEY",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.