Organization Active NPI

Innovation Therapy, LLC.

  • Occupational Therapist
  • Washington, IN
National Provider Identifier
1124668892
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
INNOVATION THERAPY, LLC.
Practice address
933 S State Road 57
Washington, IN 47501-4374
Phone
(812) 254-2203
NPI assigned
Jan 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Mrs. Adria Brianne Hawthorne, MSOT, OTRNPI 1134494883
Title
Owner, Occupational Therapist
Phone
(812) 254-2203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

933 S State Road 57
Washington, IN 47501-4374

Mailing address

7676 S 250 E
Washington, IN 47501-8031
Phone (812) 698-0198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430000953 IN Part B Supplier - Clinic/Group Practice 3476983602 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, IN

National Provider Directory

National Provider Directory

Locations

1211 S Meridian St
Ste 1
Washington, IN 47501
Phone (812) 254-2203

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1124668892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7676 S 250 E",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475018031",
            "telephone_number": "812-698-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 S STATE ROAD 57",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014374",
            "telephone_number": "812-254-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION THERAPY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "ADRIA",
        "authorized_official_middle_name": "BRIANNE",
        "authorized_official_title_or_position": "OWNER, OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "812-254-2203",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSOT, OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.