Individual provider Active NPI

Mia Theado, OTR/L

  • Occupational Therapist
  • Columbus, OH
National Provider Identifier
1043840440
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-5405 Issued in OH
Practice address
53 Westwood Rd
Columbus, OH 43214-3015
Phone
(614) 937-3365
NPI assigned
Jan 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 OT-5405 OH Primary

Addresses

Primary practice location

53 Westwood Rd
Columbus, OH 43214-3015

Mailing address

53 Westwood Rd
Columbus, OH 43214-3015
Phone (614) 937-3365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200316001512 OH Practitioner - Occupational Therapist in Private Practice 8123456696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affordable Home Health Care LLC 42 clinicians

Practice addresses (Care Compare)

800 Yard St
Suite 300
Grandview Heights, OH 43212-3882
Phone (614) 866-8158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-5405OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Home Health Care, LLC Current Accepting new patients
Affordable Home Health Care, LLC Occupational Therapist CurrentSince Feb 6, 2020 Accepting new patients

Locations

800 Yard St
Ste 300
Grandview Heights, OH 43212
Phone (614) 866-8158

Organizations & group practices 3

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1043840440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WESTWOOD RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143015",
            "telephone_number": "614-937-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 WESTWOOD RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143015",
            "telephone_number": "614-937-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEADO",
        "first_name": "MIA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT-5405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.