Active NPI
Barbara Jo Gossack, OTR
- Occupational Therapist
- Costa Mesa, CA
National Provider Identifier
1083871750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14041
- Practice address
- 543 W Wilson St Apt C1
Costa Mesa, CA 92627-2460 - Phone
- (503) 997-9940
- NPI assigned
- May 20, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1007458 | OR | |
| Occupational Therapist | 225X00000X | 14041 | CA | Primary |
| Occupational Therapist | 225X00000X | 5288 | AZ |
Addresses
Primary practice location
543 W Wilson St Apt C1
Costa Mesa, CA 92627-2460
Mailing address
543 W Wilson St Apt C1
Costa Mesa, CA 92627-2460
Phone (503) 997-9940
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 |
|---|---|---|---|
| 5288 | AZ | MD | Orthopedic Physical Therapist |
| 14041 | CA | MD | Occupational Therapist |
| 1007458 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1083871750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "543 W WILSON ST APT C1",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272460",
"telephone_number": "503-997-9940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "543 W WILSON ST APT C1",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272460",
"telephone_number": "503-997-9940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSSACK",
"first_name": "BARBARA",
"middle_name": "JO",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-20",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "1007458",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "14041",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "5288",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.