Individual provider Active NPI

Charles J Jansen, M.ED, OTR

  • Ergonomics Occupational Therapist
  • Evansville, IN
National Provider Identifier
1871704213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ergonomics Occupational TherapistTaxonomy code 225XE1200X
License
31000105A Issued in IN
Practice address
3700 Washington Ave
Evansville, IN 47750-0001
Phone
(812) 485-5603
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ergonomics Occupational Therapist 225XE1200X 31000105A IN Primary

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47750-0001

Mailing address

3700 Washington Ave
Evansville, IN 47750-0001
Phone (812) 485-5603

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
31000105AINMDErgonomics Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871704213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "812-485-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477500001",
            "telephone_number": "812-485-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "M.ED, OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "IN",
            "license": "31000105A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

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.

Verify at the official NPI Registry.