Sally Marie Nurse, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31000786A Issued in IN

Practice address

6635 East 21St Street
Suite 100 West Building
Indianapolis, IN 46219-2254

Phone

(317) 608-2824

Fax

(765) 454-9759

NPI assigned

Sep 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sally Cobb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1504483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1083132690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "765-454-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6635 EAST 21ST STREET",
            "address_2": "SUITE 100 WEST BUILDING",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192254",
            "telephone_number": "317-608-2824",
            "fax_number": "765-454-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURSE",
        "first_name": "SALLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-04",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000786A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "COBB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.