Karen Lee Petty

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-1626 Issued in ID

Practice address

1220 Montana St
101
Gooding, ID 83330-1856

Phone

(208) 934-5601

NPI assigned

Oct 25, 2016

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mobileyes Health Care PLLC

  • Optometrist
  • Nampa, ID
  • NPI 1598137317
  NPD (past)
• Mobilitycares LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1700440948
  NPD (past)

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1154873248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 W NEZ PERCE ST",
            "address_2": "APT 324",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052959",
            "telephone_number": "208-919-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MONTANA ST",
            "address_2": "101",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301856",
            "telephone_number": "208-934-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "KAREN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "OTA-1626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan A. Ormond, RD, LD, CDE
• Anna Delaney Owen
• Sierra Ann Oyler, PA-C
• Peak Medical of Boise, LLC
• Ty Peterson, DMD
• Christina Ann Pickett, RDN, LD
• Pro Active Advantage, LLC
• Pro Active Advantage, LLC
• Pro Active Advantage, LLC
• Thomas Ernest Pryor, MD

• Occupational Therapy Assistant in Gooding, ID
• Providers in Gooding, ID by specialty
• Occupational Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.