Active NPI
Warren J Mundrick, OT
- Occupational Therapist
- Utica, NY
National Provider Identifier
1093957912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 004081-1
- Practice address
- 2150 Bleecker St
Utica, NY 13501-1738 - Phone
- (315) 798-4867
- Fax
- (315) 798-4944
- NPI assigned
- Mar 25, 2009
- 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 Therapist | 225X00000X | 004081-1 | NY | Primary |
Addresses
Primary practice location
2150 Bleecker St
Utica, NY 13501-1738
Mailing address
2150 Bleecker St
Utica, NY 13501
Phone (315) 798-4867
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004081-1 | Other | NY | LICENSE |
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 |
|---|---|---|---|
| 004081-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237939200000",
"number": "1093957912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 BLEECKER ST",
"city": "UTICA",
"state": "NY",
"postal_code": "13501",
"telephone_number": "315-798-4867",
"fax_number": "315-798-4944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 BLEECKER ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135011738",
"telephone_number": "315-798-4867",
"fax_number": "315-798-4944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNDRICK",
"first_name": "WARREN",
"middle_name": "J",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-25",
"last_updated": "2009-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "004081-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "004081-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.