Active NPI
Mary Crane Elliott, OT
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1073610937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2090
- Practice address
- 5501 Tioga Rd NW
Albuquerque, NM 87120-2350 - Phone
- (505) 301-0815
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2090 | NM | Primary |
Addresses
Primary practice location
5501 Tioga Rd NW
Albuquerque, NM 87120-2350
Mailing address
5501 Tioga Rd NW
Albuquerque, NM 87120-2350
Phone (505) 301-0815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24428051 | Medicaid | NM |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1073610937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5501 TIOGA RD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871202350",
"telephone_number": "505-301-0815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 TIOGA RD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871202350",
"telephone_number": "505-301-0815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "MARY",
"middle_name": "CRANE",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "2090",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24428051",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.