Individual provider Active NPI

Erin Anderson, COTA

  • Occupational Therapy Assistant
  • Carbondale, IL
National Provider Identifier
1114482734
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.0003265 Issued in IL
Practice address
2595 S Wolf Creek Rd
Carbondale, IL 62902-0572
Phone
(618) 889-9244
NPI assigned
Feb 7, 2019
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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 057.0003265 IL Primary

Addresses

Primary practice location

2595 S Wolf Creek Rd
Carbondale, IL 62902-0572

Mailing address

2595 S Wolf Creek Rd
Carbondale, IL 62902-0572
Phone (618) 889-9244

Other names 1

  • Erin Abney Former name

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
057.0003265ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1114482734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 S WOLF CREEK RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629020572",
            "telephone_number": "618-889-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 S WOLF CREEK RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629020572",
            "telephone_number": "618-889-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.0003265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "ABNEY",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.