Tammy Earlene Prevatke, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA004869 Issued in AZ

Practice address

2470 S Arizona Ave
Yuma, AZ 85364-8520

Phone

(928) 344-8541

NPI assigned

Apr 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1144803115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13493 E 51ST LN",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853676569",
            "telephone_number": "928-581-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 S ARIZONA AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648520",
            "telephone_number": "928-344-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVATKE",
        "first_name": "TAMMY",
        "middle_name": "EARLENE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA004869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexie Poole
• Shannon Portz Robinson
• Mary Kathleen Powell, FNP
• Elizabeth Lee Powers - Tolman, MSW, LCSW
• Antonella Preciado
• Rachel Lindsey Price, M.A. CCC-SLP
• Ryan H Price, PA-C
• Jean R Priester-Mudd
• Rafael Prieto Moreno, MA, BCBA, LBA
• Carolina Prieto, PSY. D.

• Occupational Therapy Assistant in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.