Organization Active NPI

Skill Builders Therapy LLC

  • Occupational Therapist
  • Fairfield, IL
National Provider Identifier
1841728474
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
SKILL BUILDERS THERAPY LLC
Practice address
1023 US Highway 45
Fairfield, IL 62837-2909
Phone
(618) 895-4260
Fax
(618) 551-8835
NPI assigned
May 26, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Deana Lynne Hostettler, MSOTR/L
Title
Manager
Phone
(618) 895-4260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X IL Primary

Addresses

Primary practice location

1023 US Highway 45
Fairfield, IL 62837-2909

Mailing address

1023 US Highway 45
Fairfield, IL 62837-2909
Phone (618) 895-4260

Other identifiers 1

IdentifierTypeStateIssuer
332727850001MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1841728474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 US HIGHWAY 45",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372909",
            "telephone_number": "618-895-4260",
            "fax_number": "618-551-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 US HIGHWAY 45",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372909",
            "telephone_number": "618-895-4260",
            "fax_number": "618-551-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILL BUILDERS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HOSTETTLER",
        "authorized_official_first_name": "DEANA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "618-895-4260",
        "authorized_official_credential": "MSOTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332727850001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.