Gina Anne Malito, MOT, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

001832 Issued in IA

Practice address

1377 11TH St NW
Clinton, IA 52732-5068

Phone

(563) 241-4230

Fax

(563) 241-4235

NPI assigned

Jun 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sweet Pea's Therapy, LLC

  • Speech-Language Pathologist
  • Davenport, IA
  • NPI 1164792966

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1033316872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 W 38TH PL",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065503",
            "telephone_number": "563-940-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 11TH ST NW",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325068",
            "telephone_number": "563-241-4230",
            "fax_number": "563-241-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALITO",
        "first_name": "GINA",
        "middle_name": "ANNE",
        "credential": "MOT, OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "001832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "I20672",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665711",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58204",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyudmyla Lyashenko
• Lynnway Counseling, LLC
• Mary Maddasion, ARNP
• Ricky Maddox, MD
• Robert Edward Magnus, M.D.
• Jerilynn Malli, LISW
• Michael Nasr Mankarious, M.D.
• Paul G Manning, M.D.
• Elpidio G Mariano, MD
• Mel G Marilim, M.D.

• Occupational Therapist in Clinton, IA
• Providers in Clinton, IA by specialty
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.