Active NPI
Rachel Iannucci, C.O.T.A.
- Occupational Therapy Assistant
- Surprise, AZ
National Provider Identifier
1093074775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1561
- Practice address
- 11405 North Greer Ranch Parkway
Surprise, AZ 85379 - Phone
- (623) 523-8550
- NPI assigned
- May 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 1561 | AZ | Primary |
Addresses
Primary practice location
11405 North Greer Ranch Parkway
Surprise, AZ 85379
Mailing address
14620 West Red Bird Road
Surprise, AZ 85387
Phone (623) 570-9632
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 |
|---|---|---|---|
| 1561 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337040000000",
"number": "1093074775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14620 WEST RED BIRD ROAD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "85387",
"telephone_number": "623-570-9632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11405 NORTH GREER RANCH PARKWAY",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "85379",
"telephone_number": "623-523-8550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNUCCI",
"first_name": "RACHEL",
"credential": "C.O.T.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-15",
"last_updated": "2012-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "1561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.