Active NPI
Brian Simpson
- Environmental Modification Occupational Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1114453206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Environmental Modification Occupational Therapy Assistant
- License
- 6827
- Practice address
- 15645 N 35TH Ave
Apt 109
Phoenix, AZ 85053-3839 - Phone
- (931) 278-3962
- NPI assigned
- May 10, 2017
- 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 |
|---|---|---|---|---|
| Environmental Modification Occupational Therapy Assistant | 224ZE0001X | 6827 | AZ | Primary |
Addresses
Primary practice location
15645 N 35TH Ave
Apt 109
Phoenix, AZ 85053-3839
Mailing address
15645 N 35TH Ave
Apt 109
Phoenix, AZ 85053-3839
Phone (931) 278-3962
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 |
|---|---|---|---|
| 6827 | AZ | MD | Environmental Modification Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1114453206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15645 N 35TH AVE",
"address_2": "APT 109",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850533839",
"telephone_number": "931-278-3962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15645 N 35TH AVE",
"address_2": "APT 109",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850533839",
"telephone_number": "931-278-3962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPSON",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-10",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "224ZE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Environmental Modification",
"state": "AZ",
"license": "6827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.