Individual provider Active NPI

Carol J. Morehouse, OTR/L

  • Occupational Therapist
  • Bloomfield, NM
National Provider Identifier
1033425152
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2490 Issued in NM
Practice address
325 N Bergin LN
Bloomfield, NM 87413-6729
Phone
(505) 634-3946
Fax
(505) 634-3950
NPI assigned
Aug 26, 2010
Last updated
Aug 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2490 NM Primary

Addresses

Primary practice location

325 N Bergin LN
Bloomfield, NM 87413-6729

Mailing address

325 N Bergin LN
Bloomfield, NM 87413-6729
Phone (505) 634-3946

Other identifiers 1

IdentifierTypeStateIssuer
64434826MedicaidNM

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
2490NMMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1033425152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N BERGIN LN",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136729",
            "telephone_number": "505-634-3946",
            "fax_number": "505-634-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N BERGIN LN",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136729",
            "telephone_number": "505-634-3946",
            "fax_number": "505-634-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREHOUSE",
        "first_name": "CAROL",
        "middle_name": "J.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "2490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64434826",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.