Individual provider Active NPI

Jodie Reitz, COTA

  • Occupational Therapy Assistant
  • Colorado Springs, CO
National Provider Identifier
1154981405
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0001191 Issued in CO
Practice address
12105 Ambassador Dr
Colorado Springs, CO 80921-3642
Phone
(800) 335-1060
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4810 CA
Occupational Therapy Assistant 224Z00000X 0001191 CO Primary

Addresses

Primary practice location

12105 Ambassador Dr
Colorado Springs, CO 80921-3642

Mailing address

3625 Rialto HTS # 3-042
Colorado Springs, CO 80907-8631
Phone (559) 978-1508

Other practice location 1

3625 Rialto Hts # 3-042
Colorado Springs, CO 80907-8631
Phone (559) 978-1508

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
4810CAMDSurgery Physician
0001191COMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1154981405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 RIALTO HTS # 3-042",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078631",
            "telephone_number": "559-978-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 AMBASSADOR DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213642",
            "telephone_number": "800-335-1060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3625 Rialto Hts # 3-042",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809078631",
            "country_code": "US",
            "telephone_number": "559-978-1508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REITZ",
        "first_name": "JODIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "4810",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "0001191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.