MRS. JESSICA JANELLE WATERS (OTR) – Occupational Therapist, NPI 1689836793

MRS. JESSICA JANELLE WATERS (OTR) is a healthcare provider. based in Norris city, Illinois. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 056007162 (IL). The NPI Number for MRS. JESSICA JANELLE WATERS (OTR) is 1689836793

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JESSICA JANELLE WATERS (OTR)
NPI
1689836793
Phone
(618) 962-3070
Address
256 COUNTY ROAD 400 E
Enumeration Date
30 June 2008
Last Update Date
30 June 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6309472717
Graduation Year
2003 (23 years ago)
PAC ID
6800248238
Group Practice PAC ID
5193036432
Professional Enrollment ID
I20240122000629
Address ID
IL605322179LI1920XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

973 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in IL

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Provider Addresses for MRS. JESSICA JANELLE WATERS (OTR)

  • 256 COUNTY ROAD 400 E

    NORRIS CITY, IL 628693909

    Phone: (618) 962-3070

    Type: Mailing

  • College Boulevard, Milan, Carmi, White County, Illinois, 62821, United States

    CARMI, IL 628211548

    Phone: (618) 382-2923

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240122000629IOccupational Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62869)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193036432View full group profile
NameSpecialtyState
-MO
-AL
-IL
Qualified Speech Language PathologistFL
-MO
Occupational Therapist In Private PracticeUT
Physical Therapist In Private PracticeWI
-WI
-WI
-FL

Reviews

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Frequently asked questions

Is there an official ID for MRS. JESSICA JANELLE WATERS (OTR) in U.S. healthcare records?
The official identifier for MRS. JESSICA JANELLE WATERS (OTR) is NPI 1689836793.
Is there an active status for MRS. JESSICA JANELLE WATERS (OTR)?
For scheduling context, MRS. JESSICA JANELLE WATERS (OTR) is shown as active in the registry.
How would a patient describe MRS. JESSICA JANELLE WATERS (OTR)'s focus?
For MRS. JESSICA JANELLE WATERS (OTR), the primary taxonomy reads as Occupational Therapist. Clinical services aligned with this taxonomy classification.
Is MRS. JESSICA JANELLE WATERS (OTR) located near Norris City?
MRS. JESSICA JANELLE WATERS (OTR) currently maps to Norris City, Illinois in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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