Individual provider Active NPI

Sara C Bunn, COTA

  • Occupational Therapy Assistant
  • Utica, NY
National Provider Identifier
1033419205
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
004225 Issued in NY
Practice address
1601 Armory Dr
Utica, NY 13501-5405
Phone
(315) 724-5761
Fax
(315) 738-7777
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 004225 NY Primary

Addresses

Primary practice location

1601 Armory Dr
Utica, NY 13501-5405

Mailing address

1601 Armory Dr
Utica, NY 13501-5405
Phone (315) 724-5761

Other identifiers 1

IdentifierTypeStateIssuer
00474180MedicaidNY

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
004225NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1033419205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 ARMORY DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015405",
            "telephone_number": "315-724-5761",
            "fax_number": "315-738-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 ARMORY DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015405",
            "telephone_number": "315-724-5761",
            "fax_number": "315-738-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "SARA",
        "middle_name": "C",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "004225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.