Individual provider Active NPI

William Cecrle, MOT

  • Occupational Therapist
  • Redmond, OR
National Provider Identifier
1891137006
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
312826 Issued in OR
Practice address
2398 W Antler Ave
Redmond, OR 97756-9330
Phone
(541) 408-1373
Fax
(866) 914-5194
NPI assigned
Jul 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2591 OR
Occupational Therapist 225X00000X 312826 OR Primary

Addresses

Primary practice location

2398 W Antler Ave
Redmond, OR 97756-9330

Mailing address

685 36TH Ave NE
Salem, OR 97301-4741
Phone (503) 540-8701

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Redmond

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529003397 OR Practitioner - Occupational Therapist in Private Practice 8426376492 Practice locations: Redmond, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
312826ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Northwest LLC Past Accepting new patients
Physical Therapy Northwest Limited Partnership Past Accepting new patients

Organizations & group practices 2

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1891137006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 36TH AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014741",
            "telephone_number": "503-540-8701",
            "fax_number": "503-371-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2398 W ANTLER AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977569330",
            "telephone_number": "541-408-1373",
            "fax_number": "866-914-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECRLE",
        "first_name": "WILLIAM",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "2591",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "312826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Redmond",
            "affiliation": "N",
            "address_1": "2398 W Antler Ave",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977569330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.