Active NPI
Nicole Rene Green, OTD, OTR/L
- Occupational Therapist
- Hot Springs, SD
National Provider Identifier
1043736101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1158
- Practice address
- 500 N 5TH St
Hot Springs, SD 57747-1480 - Phone
- (605) 745-2000
- NPI assigned
- Aug 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2374 | NE | |
| Occupational Therapist | 225X00000X | OT.0005127 | CO | |
| Occupational Therapist | 225X00000X | 1158 | SD | Primary |
Addresses
Primary practice location
500 N 5TH St
Hot Springs, SD 57747-1480
Mailing address
500 N 5TH St
Hot Springs, SD 57747-1480
Phone (605) 745-2000
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 |
|---|---|---|---|
| 1158 | SD | MD | Orthopaedic Surgery of the Spine Physician |
| OT.0005127 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1043736101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N 5TH ST",
"city": "HOT SPRINGS",
"state": "SD",
"postal_code": "577471480",
"telephone_number": "605-745-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N 5TH ST",
"city": "HOT SPRINGS",
"state": "SD",
"postal_code": "577471480",
"telephone_number": "605-745-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "NICOLE",
"middle_name": "RENE",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-20",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2374",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "OT.0005127",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "1158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hot Springs, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.