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Deactivated NPI 1558062174 Deactivated / Inactive NPI Female Practitioner

Jennifer Davis , COTA, L

Occupational Therapy Assistant • Bloomington, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jennifer Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 10, 2023
NPI Deactivation Date May 21, 2023
Total Practice Duration ~1 Years of Practice (2023 – 2023)

Professional Overview & Biography Verified Profile Summary

Jennifer Davis, COTA, L was a registered Occupational Therapy Assistant practicing in Bloomington, IL. Throughout an active medical career spanning 1 years, Jennifer Davis provided care at the practice location at 1412 CROXTON AVE APT 11A until profile deactivation on 2023-05-21.

Practice Location & Contact Primary Location

Practice Address

1412 Croxton Ave Apt 11a

Bloomington, IL 617017305

Telephone 3095314489

Specialty Benchmarks & Practice Insights

Comparative analytics for Occupational Therapy Assistant in Bloomington, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.5 Yrs
Regional Practice Density
15 Specialists

Practicing in Bloomington, IL (1525 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Occupational Therapy Assistant Primary Specialty

NUCC Taxonomy Code: 224Z00000X

State License IL 057002192

An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 21, 2023

Record deactivated on May 21, 2023

NPI Profile Active March 10, 2023

NPI status registered as active in NPPES database

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Updated Practice Location March 10, 2023

Registered at 1412 CROXTON AVE APT 11A, BLOOMINGTON, IL 617017305 (Tel: 3095314489)

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Updated Business Mailing Address March 10, 2023

Registered at 1412 CROXTON AVE APT 11A, BLOOMINGTON, IL 617017305 (Tel: 3095314489)

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Provider Name / Credentials Updated March 10, 2023

Recorded as JENNIFER DAVIS, COTA/L

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2023

Occupational Therapy Assistant (License #057002192 in IL)

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Initial NPI Registration & Enumeration March 10, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558062174
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 10, 2023
Last Update: March 10, 2023
Deactivation Date: May 21, 2023

Mailing Address

1412 Croxton Ave Apt 11a

Bloomington, IL 617017305

Phone: 3095314489

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.