Active NPI
Edward Leo Rising, COTA
- Occupational Therapy Assistant
- Bangor, PA
National Provider Identifier
1013115716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OP001867L
- Practice address
- 701 Slate Belt Blvd
Bangor, PA 18013-9341 - Phone
- (610) 599-1454
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | OP001867L | PA | Primary |
Addresses
Primary practice location
701 Slate Belt Blvd
Bangor, PA 18013-9341
Mailing address
396 Slateford Rd
Mount Bethel, PA 18343-5514
Phone (570) 897-6815
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP001867L | PA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013115716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 SLATEFORD RD",
"city": "MOUNT BETHEL",
"state": "PA",
"postal_code": "183435514",
"telephone_number": "570-897-6815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 SLATE BELT BLVD",
"city": "BANGOR",
"state": "PA",
"postal_code": "180139341",
"telephone_number": "610-599-1454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISING",
"first_name": "EDWARD",
"middle_name": "LEO",
"name_prefix": "Mr.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "PA",
"license": "OP001867L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.