Active NPI
Clinton David Rauch, MS, OTR/L
- Occupational Therapist
- Olney, IL
National Provider Identifier
1972132991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056012847
- Practice address
- 800 E Locust St
Olney, IL 62450-2553 - Phone
- (618) 395-7340
- NPI assigned
- Apr 2, 2020
- Sex
- Male
- 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 | 056012847 | IL | Primary |
Addresses
Primary practice location
800 E Locust St
Olney, IL 62450-2553
Mailing address
1700 Quartz LN
Ingraham, IL 62434-3014
Phone (618) 843-2694
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056012847 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1972132991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 QUARTZ LN",
"city": "INGRAHAM",
"state": "IL",
"postal_code": "624343014",
"telephone_number": "618-843-2694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E LOCUST ST",
"city": "OLNEY",
"state": "IL",
"postal_code": "624502553",
"telephone_number": "618-395-7340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUCH",
"first_name": "CLINTON",
"middle_name": "DAVID",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-02",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056012847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.