Individual provider Active NPI

Tamara Gilbreath

  • Occupational Therapy Assistant
  • Lawton, OK
National Provider Identifier
1073108619
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
807 Issued in OK
Practice address
1202 SW 27TH St
Lawton, OK 73505-7947
Phone
(580) 353-8861
NPI assigned
Mar 5, 2021
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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 807 OK Primary

Addresses

Primary practice location

1202 SW 27TH St
Lawton, OK 73505-7947

Mailing address

8154 County Road 1470
Apache, OK 73006-6600
Phone (580) 512-5828

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

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1073108619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8154 COUNTY ROAD 1470",
            "city": "APACHE",
            "state": "OK",
            "postal_code": "730066600",
            "telephone_number": "580-512-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 SW 27TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735057947",
            "telephone_number": "580-353-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBREATH",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.