Active NPI
Cindy A Bauer, OTR
- Occupational Therapist
- Maryville, IL
National Provider Identifier
1891087656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056003612
- Practice address
- 6800 State Route 162
Maryville, IL 62062-8500 - Phone
- (618) 391-6405
- Fax
- (618) 288-4088
- NPI assigned
- May 11, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 056003612 | IL | Primary |
Addresses
Primary practice location
6800 State Route 162
Maryville, IL 62062-8500
Mailing address
6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 391-6405
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 |
|---|---|---|---|
| 056003612 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305072000000",
"number": "1891087656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500",
"telephone_number": "618-391-6405",
"fax_number": "618-288-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500",
"telephone_number": "618-391-6405",
"fax_number": "618-288-4088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "CINDY",
"middle_name": "A",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-11",
"last_updated": "2011-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056003612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.