Active NPI
Amy Marie Johnson, COTA/L
- Occupational Therapy Assistant
- Wichita, KS
National Provider Identifier
1154630788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 18-00691
- Practice address
- 4700 W. 13TH St. N
Wichita, KS 67212 - Phone
- (316) 943-3092
- NPI assigned
- Sep 30, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 18-00691 | KS | Primary |
Addresses
Primary practice location
4700 W. 13TH St. N
Wichita, KS 67212
Mailing address
7733 Forsyth Boulevard
Suite 2300
St. Louis, MO 63105
Phone (800) 677-1238
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 |
|---|---|---|---|
| 18-00691 | KS | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1154630788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7733 FORSYTH BOULEVARD",
"address_2": "SUITE 2300",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63105",
"telephone_number": "800-677-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 W. 13TH ST. N",
"city": "WICHITA",
"state": "KS",
"postal_code": "67212",
"telephone_number": "316-943-3092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMY",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-30",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "KS",
"license": "18-00691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.