Individual provider Active NPI

Laura Bates-Glenn, COTA/L

  • Occupational Therapy Assistant
  • Ottumwa, IA
National Provider Identifier
1083089288
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
000969 Issued in IA
Practice address
2035 Chester Ave
Ottumwa, IA 52501-3715
Phone
(641) 684-9313
NPI assigned
Dec 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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 000969 IA Primary

Addresses

Primary practice location

2035 Chester Ave
Ottumwa, IA 52501-3715

Mailing address

559 Leighton St
Ottumwa, IA 52501-4932

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
000969IAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1083089288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 LEIGHTON ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 CHESTER AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013715",
            "telephone_number": "641-684-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES-GLENN",
        "first_name": "LAURA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IA",
            "license": "000969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.