Individual provider Active NPI

James P Mecham, MS, OTRIL

  • Occupational Therapist
  • Kenosha, WI
National Provider Identifier
1992730386
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2814026 Issued in WI
Practice address
3921 30TH Ave Ste a
Kenosha, WI 53144-1939
Phone
(866) 470-4440
Fax
(866) 520-5557
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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 056006853 IL
Occupational Therapist 225X00000X 2814026 WI Primary

Addresses

Primary practice location

3921 30TH Ave Ste a
Kenosha, WI 53144-1939

Mailing address

3921 30TH Ave Ste a
Kenosha, WI 53144-1939
Phone (866) 470-4440

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056006853ILMDOccupational Therapist
2814026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Occupro, LLC Occupational Therapist CurrentSince May 1, 2022 Accepting new patients
Sports Physical Therapy & Rehabilitation Specialists S.C. Occupational Therapist PastSince May 1, 2022 Accepting new patients

Locations

3921 30th Ave
Ste A
Kenosha, WI 53144
Phone (262) 925-0311

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1992730386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 30TH AVE STE A",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441939",
            "telephone_number": "866-470-4440",
            "fax_number": "866-520-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 30TH AVE STE A",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441939",
            "telephone_number": "866-470-4440",
            "fax_number": "866-520-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECHAM",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "MS, OTRIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056006853",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2814026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.