Individual provider Active NPI

Connie Lynn Faulkner, COTA/L

  • Occupational Therapy Assistant
  • Olathe, KS
National Provider Identifier
1104197672
Registry record updated Jan 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
18-00280 Issued in KS
Practice address
201 E Flaming Rd
Olathe, KS 66061-5343
Phone
(913) 829-2273
NPI assigned
Jan 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18-00280 KS Primary

Addresses

Primary practice location

201 E Flaming Rd
Olathe, KS 66061-5343

Mailing address

6545 Switzer St
Shawnee, KS 66203-3938
Phone (913) 220-6944

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

LicenseStateTypeSpecialty
18-00280KSMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326585600000",
    "number": "1104197672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 SWITZER ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033938",
            "telephone_number": "913-220-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E FLAMING RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615343",
            "telephone_number": "913-829-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-15",
        "last_updated": "2012-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "18-00280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.

Verify at the official NPI Registry.