Active NPI
Charles Ray Gadd, COTAL
- Occupational Therapy Assistant
- Mansfield, OH
National Provider Identifier
1083812010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA01177
- Practice address
- 1750 W 4TH St
Medcentral Health System
Mansfield, OH 44906 - Phone
- (419) 526-8212
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | OTA01177 | OH | Primary |
Addresses
Primary practice location
1750 W 4TH St
Medcentral Health System
Mansfield, OH 44906
Mailing address
7326 St Rte 19
Unit 2514
Mt Gilead, OH 43338
Phone (419) 946-1457
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 |
|---|---|---|---|
| OTA01177 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1083812010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7326 ST RTE 19",
"address_2": "UNIT 2514",
"city": "MT GILEAD",
"state": "OH",
"postal_code": "43338",
"telephone_number": "419-946-1457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 W 4TH ST",
"address_2": "MEDCENTRAL HEALTH SYSTEM",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44906",
"telephone_number": "419-526-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADD",
"first_name": "CHARLES",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "COTAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-11",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA01177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.