Individual provider Active NPI

Manuela Lindsey, COTA

  • Occupational Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1053755157
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32002354A Issued in IN
Practice address
336 W Creighton Ave
Fort Wayne, IN 46807-1330
Phone
(260) 442-4556
NPI assigned
Apr 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32002354A IN Primary
Occupational Therapy Assistant 224Z00000X 212056 TX

Addresses

Primary practice location

336 W Creighton Ave
Fort Wayne, IN 46807-1330

Mailing address

336 W Creighton Ave
Fort Wayne, IN 46807-1330
Phone (260) 442-4556

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
32002354AINMDOccupational Therapy Assistant
212056TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1053755157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W CREIGHTON AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071330",
            "telephone_number": "260-442-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W CREIGHTON AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071330",
            "telephone_number": "260-442-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSEY",
        "first_name": "MANUELA",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002354A",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212056",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.