Individual provider Active NPI

Hannah Golden, MOTR/L

  • Occupational Therapist
  • Idaho Falls, ID
National Provider Identifier
1083196380
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-1922 Issued in ID
Practice address
1460 Elk Creek
Idaho Falls, ID 83404
Phone
(208) 535-1286
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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 OT-1922 ID Primary

Addresses

Primary practice location

1460 Elk Creek
Idaho Falls, ID 83404

Mailing address

1541 S 4TH Ave
Pocatello, ID 83201-6838
Phone (208) 863-8733

Other names 1

  • Hannah Tull Former name

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
OT-1922IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Star Speech and Occupational Therapy LLC CurrentSince Jan 1, 2023 Accepting new patients
Mountain View Hospital LLC Past Accepting new patients
Speech and Language Clinic, Inc Past Accepting new patients

Locations

12222 W Bridger Bay Dr
Star, ID 83669
Phone (208) 391-2773

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1083196380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 S 4TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016838",
            "telephone_number": "208-863-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 ELK CREEK",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-535-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "HANNAH",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "TULL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.