KELLSIE A EDGCOMB OT
NPI 1376217216
Occupational Therapist in Utica, IL

Active since August 04, 2021
552 E US HIGHWAY 52, UTICA, IL 61373(815) 915-9460 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kellsie A Edgcomb Ot NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLSIE A EDGCOMB OT (NPI 1376217216) is an individual occupational therapist in Utica, Illinois, licensed in Illinois (056016950) and active in the NPI registry since August 2021. She maintains a secondary practice location in Edwardsville and is a graduate of Other (2025).

NPPES Registry Identity

NPI1376217216
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameKELLSIE A EDGCOMBCredential: OT
Location Address552 E US HIGHWAY 52Utica, IL 61373-9766
Mailing Address552 E Us Highway 52Utica, IL 61373-9766
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 4, 2021
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1376217216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in IL · 056016950
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and 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 therapists 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.
Also ListedBehavior TechnicianTaxonomy 106S00000X
552 E US HIGHWAY 52, Utica, IL 61373

Secondary Practice Location 1

Location 12122 Troy Rd Ste 120Edwardsville, IL 62025-2540 · Phone (618) 800-4620

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kellsie A Edgcomb Ot is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294299558
PECOS Enrollment IDI20260708004077

Medicare Billing Reassignment

Medicare enrollment records show Kellsie Edgcomb reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Multi-Specialty
2122 TROY RD STE 120
Edwardsville, IL 62025
  • Reassigned Medicare billing, Illinois enrollment
  • 13 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellsie Edgcomb's NPI number?

The NPI number for Kellsie Edgcomb is 1376217216. It was assigned to this individual provider in the NPPES registry on August 4, 2021.

Where is Kellsie Edgcomb located?

Kellsie Edgcomb practices at 552 E Us Highway 52, Utica, IL 61373. The listed phone number is (815) 915-9460.

What is Kellsie Edgcomb's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Kellsie Edgcomb enrolled in Medicare?

Yes. Kellsie Edgcomb is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kellsie Edgcomb's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kellsie Edgcomb reassigns Medicare benefits to Childrens Illinois Inc (Edwardsville, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kellsie Edgcomb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kellsie Edgcomb was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.