Individual provider Active NPI

Larson Brinker, COTAL

  • Occupational Therapy Assistant
  • Tulsa, OK
National Provider Identifier
1023724846
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2457 Issued in OK
Practice address
3312 S Peoria Ave
Tulsa, OK 74105-2029
Phone
(918) 400-0089
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X 2457 OK Primary

Addresses

Primary practice location

3312 S Peoria Ave
Tulsa, OK 74105-2029

Mailing address

PO Box 438
Glenpool, OK 74033-0438
Phone (918) 720-6809

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
2457OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Therapy Center, Inc. Multi-Specialty CurrentSince Feb 11, 2024 Accepting new patients
Einstein Therapy Center, Inc. Multi-Specialty PastSince Jan 29, 2023 Accepting new patients

Locations

3312 S Peoria Ave
Tulsa, OK 74105
Phone (918) 392-1913

Organizations & group practices 2

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": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1023724846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740330438",
            "telephone_number": "918-720-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052029",
            "telephone_number": "918-400-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKER",
        "first_name": "LARSON",
        "credential": "COTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.