Active NPI
Rebecca Skylar Fredrickson, OTD, OTR/L
- Occupational Therapist
- Greeley, CO
National Provider Identifier
1013753193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.0008497
- Practice address
- 5699 W 20TH St
Greeley, CO 80634-3165 - Phone
- (970) 451-1234
- NPI assigned
- Jul 8, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT.0008497 | CO | |
| Occupational Therapist | 225X00000X | OT.0008497 | CO | Primary |
Addresses
Primary practice location
5699 W 20TH St
Greeley, CO 80634-3165
Mailing address
4248 Dixon St
Timnath, CO 80525-9010
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 |
|---|---|---|---|
| OT.0008497 | CO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liberty Homecare LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1013753193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4248 DIXON ST",
"city": "TIMNATH",
"state": "CO",
"postal_code": "805259010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5699 W 20TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806343165",
"telephone_number": "970-451-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICKSON",
"first_name": "REBECCA",
"middle_name": "SKYLAR",
"credential": "OTD, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-08",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CO",
"license": "OT.0008497",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "OT.0008497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.