Omar Medina, COTAL

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131002-093 Issued in VA

Practice address

235 Dunlop Farms Blvd
Colonial Heights, VA 23834-1792

Phone

(804) 937-4096

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1083336630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 APPLEFORD DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238317091",
            "telephone_number": "804-937-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 DUNLOP FARMS BLVD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341792",
            "telephone_number": "804-937-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "OMAR",
        "credential": "COTAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131002-093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tawanda McPhatter, LPC
• Robert McVay
• Raymond Lee Meade, D.D.S.
• Aaron Joseph Meadows, PHARMD
• Clinton Mitchell Meadows, DDS
• Medlog, LLC
• Urvashi Mehta, LCSW
• Hamere B. Mekonnen, MD
• Sophie Nash Messinger
• Angela Michelle Miller, OTR

• Occupational Therapy Assistant in Colonial Heights, VA
• Providers in Colonial Heights, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.