Renea Outlaw, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

3630 Issued in AL

Practice address

1945 Davis Dr
Gadsden, AL 35904-3276

Phone

(256) 543-1030

NPI assigned

May 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1104237023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 7TH ST S",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388213616",
            "telephone_number": "662-640-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 DAVIS DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359043276",
            "telephone_number": "256-543-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "RENEA",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "TA2835",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AL",
            "license": "3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Occupational Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.

Verify at the official NPI Registry.