Active NPI
India Blakely
- Occupational Therapist
- Mesa, AZ
National Provider Identifier
1083577423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-009798
- Practice address
- 5121 E Broadway Rd
Mesa, AZ 85206-1305 - Phone
- (334) 722-0049
- NPI assigned
- Dec 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-009798 | AZ | Primary |
Addresses
Primary practice location
5121 E Broadway Rd
Mesa, AZ 85206-1305
Mailing address
1731 Henderson Hwy
Troy, AL 36079-8221
Phone (334) 722-0049
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-009798 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1083577423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1731 HENDERSON HWY",
"city": "TROY",
"state": "AL",
"postal_code": "360798221",
"telephone_number": "334-722-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5121 E BROADWAY RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852061305",
"telephone_number": "334-722-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKELY",
"first_name": "INDIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-03",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-009798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.