Individual provider Active NPI

Colette Michelle Yardley, COTA

  • Occupational Therapy Assistant
  • Chadron, NE
National Provider Identifier
1124474895
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
981 Issued in NE
Practice address
303 Lake St
Chadron, NE 69337-2218
Phone
(502) 819-6395
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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 981 NE Primary

Addresses

Primary practice location

303 Lake St
Chadron, NE 69337-2218

Mailing address

303 Lake St
Chadron, NE 69337-2218
Phone (502) 819-6395

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
981NEMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1124474895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 LAKE ST",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693372218",
            "telephone_number": "502-819-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 LAKE ST",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693372218",
            "telephone_number": "502-819-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARDLEY",
        "first_name": "COLETTE",
        "middle_name": "MICHELLE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NE",
            "license": "981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chadron, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.