Active NPI
Carrie Sue Edwards, OTR
- Occupational Therapist
- Yuma, AZ
National Provider Identifier
1003956566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2666
- Practice address
- 450 W 6TH St
Yuma, AZ 85364-2973 - Phone
- (928) 502-4300
- NPI assigned
- Feb 7, 2007
- Last updated
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2666 | AZ | Primary |
Addresses
Primary practice location
450 W 6TH St
Yuma, AZ 85364-2973
Mailing address
11180 E 27TH St
Yuma, AZ 85367-7292
Phone (928) 246-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 803892 | Medicaid | AZ |
Other names 1
- Carrie Sue Clarke
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2666 | AZ | MD | Occupational Therapist |
| 002155 | IA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality Rehabilitation Network Inc | Past | Accepting new patients | |
| Yuma Elementary School District One | Past | Accepting new patients | |
| Assisted Living Concepts Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Copper Hills House
- Assisted Living Facility
- Yuma, AZ
- NPI 1922124494
-
- Physical Therapist
- Yuma, AZ
- NPI 1427275015
-
- Student in an Organized Health Care Education/Training Program
- Yuma, AZ
- NPI 1598811382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1003956566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11180 E 27TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853677292",
"telephone_number": "928-246-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W 6TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853642973",
"telephone_number": "928-502-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "CARRIE SUE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "2666",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "803892",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CARRIE SUE",
"last_name": "CLARKE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.