Individual provider Active NPI

Deborah Ann Nakayama, COTA/L

  • Occupational Therapy Assistant
  • Oak Lawn, IL
National Provider Identifier
1154665479
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.000009 Issued in IL
Practice address
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone
(708) 684-5425
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2013

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 057.000009 IL Primary

Addresses

Primary practice location

4440 W 95TH St
Oak Lawn, IL 60453-2600

Mailing address

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-5425

Other names 1

  • Deborah Ann Burke 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
057.000009ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1154665479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAYAMA",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.000009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "BURKE",
            "middle_name": "ANN",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.