Individual provider Active NPI

Caryl D Johnson, OT CHT

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1073694022
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0033341 Issued in NY
Practice address
160 W 66TH St
Suite 37-J
New York, NY 10023-6555
Phone
(212) 721-0460
Fax
(646) 559-2792
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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 0033341 NY Primary

Addresses

Primary practice location

160 W 66TH St
Suite 37-J
New York, NY 10023-6555

Mailing address

PO Box 237046
Ansonia Station
New York, NY 10023-0028
Phone (212) 721-0460

Other identifiers 2

IdentifierTypeStateIssuer
P391770OtherOXFORD
Q5962Q5061OtherNYMEDICARE

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

State licenses

LicenseStateTypeSpecialty
0033341NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1073694022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237046",
            "address_2": "ANSONIA STATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100230028",
            "telephone_number": "212-721-0460",
            "fax_number": "646-559-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W 66TH ST",
            "address_2": "SUITE 37-J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236555",
            "telephone_number": "212-721-0460",
            "fax_number": "646-559-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARYL",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "OT CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0033341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P391770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q5962Q5061",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.