Individual provider Active NPI

Sierra Maxwell

  • Pediatric Occupational Therapist
  • Colorado Springs, CO
National Provider Identifier
1164193892
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT.0006999 Issued in CO
Practice address
5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone
(719) 598-5555
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT.0006999 CO Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669

Mailing address

3720 Thundercloud Dr
Colorado Springs, CO 80920-4971

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
OT.0006999COMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Inc. CurrentSince Sep 28, 2021 Accepting new patients
Nurture Home Health Care Inc PastSince Sep 28, 2021 Accepting new patients
Burns & Hunsaker LLC Pediatrics Past Accepting new patients

Locations

5446 N Academy Blvd
Ste 204
Colorado Springs, CO 80918
Phone (719) 400-7612

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1164193892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 THUNDERCLOUD DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "SIERRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "OT.0006999",
            "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 Sep 22, 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.