Active NPI
Sima A Kothary, COTA/L
- Clinical Exercise Physiologist
- Anaheim, CA
National Provider Identifier
1013384023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- License
- OTA2189
- Practice address
- 3415 W Ball Rd
Anaheim, CA 92804-3708 - Phone
- (714) 826-8950
- NPI assigned
- Aug 25, 2015
- 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 |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | OTA2189 | CA | Primary |
Addresses
Primary practice location
3415 W Ball Rd
Anaheim, CA 92804-3708
Mailing address
3415 W Ball Rd
Anaheim, CA 92804-3708
Phone (714) 826-8950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 284122 | Other | CA | NBCOT |
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 |
|---|---|---|---|
| OTA2189 | CA | MD | Clinical Exercise Physiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440460800000",
"number": "1013384023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928043708",
"telephone_number": "714-826-8950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928043708",
"telephone_number": "714-826-8950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTHARY",
"first_name": "SIMA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-25",
"last_updated": "2015-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "CA",
"license": "OTA2189",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCOT",
"identifier": "284122",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.