Individual provider Active NPI

Amalia Beard, MOT, OTR

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1013126010
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1070306 NBCOT Issued in CO
Practice address
5412 Idylwild TRL
Boulder, CO 80301-3571
Phone
(303) 579-6149
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1070306 NBCOT CO Primary

Addresses

Primary practice location

5412 Idylwild TRL
Boulder, CO 80301-3571

Mailing address

18 Wildcat LN
Boulder, CO 80304-0461
Phone (303) 579-6149

Other identifiers 2

IdentifierTypeStateIssuer
04523245MedicaidCO
1070306 NBCOTOtherCOLICENSE NUMBER

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

LicenseStateTypeSpecialty
1070306 NBCOTCOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013126010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WILDCAT LN",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803040461",
            "telephone_number": "303-579-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 IDYLWILD TRL",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013571",
            "telephone_number": "303-579-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "AMALIA",
        "credential": "MOT, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "1070306 NBCOT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04523245",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1070306 NBCOT",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.