Mara Childers

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

BOTOCT00222178 Issued in KY

Practice address

4777 Ky Route 850
Hippo, KY 41653-8331

Phone

(606) 791-7435

NPI assigned

Sep 2, 2015

Last updated

Sep 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bluegrass Therapy PLLC

  • Clinic/Center
  • Prestonsburg, KY
  • NPI 1063066009
  Authorized official Same address or phone
• Bluegrass Family Chiropractic PLLC

  • Chiropractor
  • Prestonsburg, KY
  • NPI 1780118877
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1003284480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 KY ROUTE 850",
            "city": "HIPPO",
            "state": "KY",
            "postal_code": "416538331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 KY ROUTE 850",
            "city": "HIPPO",
            "state": "KY",
            "postal_code": "416538331",
            "telephone_number": "606-791-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "MARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "BOTOCT00222178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.