Active NPI
Chelsea Bailey, MS OTR/L
- Occupational Therapist
- Lake Havasu City, AZ
National Provider Identifier
1093181968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6297
- Practice address
- 1515 N. Lake Havasu Avenue
Suite #100
Lake Havasu City, AZ 86404 - Phone
- (928) 854-5439
- Fax
- (928) 854-5440
- NPI assigned
- Aug 14, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 63 019870 | NY | |
| Occupational Therapist | 225X00000X | 6297 | AZ | Primary |
Addresses
Primary practice location
1515 N. Lake Havasu Avenue
Suite #100
Lake Havasu City, AZ 86404
Mailing address
1515 N. Lake Havasu Avenue
Suite #100
Lake Havasu City, AZ 86404
Phone (928) 854-5439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 077216 | Medicaid | AZ |
Other names 1
- Miss Chelsea Bogino
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6297 | AZ | MD | Pharmacist |
| 63 019870 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milemarkers Therapy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Lake Havasu City, AZ
- NPI 1649287327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509408000000",
"number": "1093181968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N. LAKE HAVASU AVENUE",
"address_2": "SUITE #100",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "86404",
"telephone_number": "928-854-5439",
"fax_number": "928-854-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 N. LAKE HAVASU AVENUE",
"address_2": "SUITE #100",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "86404",
"telephone_number": "928-854-5439",
"fax_number": "928-854-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "CHELSEA",
"name_prefix": "Mrs.",
"credential": "MS OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-14",
"last_updated": "2017-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "63 019870",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "6297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "077216",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHELSEA",
"last_name": "BOGINO",
"prefix": "MISS",
"credential": "MS OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.