Individual provider Active NPI

Caroline Olivia Menser, OTD, OTR/L

  • Occupational Therapist
  • Idaho Falls, ID
National Provider Identifier
1104600725
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2817 Issued in ID
Practice address
1460 Elk Creek Dr
Idaho Falls, ID 83404-8237
Phone
(208) 535-1286
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 264194 KY
Occupational Therapist 225X00000X 16217 NC
Occupational Therapist 225X00000X OT-2817 ID Primary

Addresses

Primary practice location

1460 Elk Creek Dr
Idaho Falls, ID 83404-8237

Mailing address

451 W 5TH St
Russellville, KY 42276-1407
Phone (270) 772-4886

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
OT-2817IDMDOccupational Therapist
264194KYMDOccupational Therapist
16217NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Language Clinic, Inc PastSince Sep 5, 2023 Accepting new patients
Mountain View Hospital LLC PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1104600725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 W 5TH ST",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422761407",
            "telephone_number": "270-772-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048237",
            "telephone_number": "208-535-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSER",
        "first_name": "CAROLINE",
        "middle_name": "OLIVIA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "264194",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16217",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.