Individual provider Active NPI

Adana Nikkia Gibson, C.O.T.A

  • Occupational Therapy Assistant
  • Yonkers, NY
National Provider Identifier
1174077689
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
008787-1 Issued in NY
Practice address
420 Palisade Ave
1D
Yonkers, NY 10703-2651
Phone
(914) 338-6857
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 008787-1 NY Primary

Addresses

Primary practice location

420 Palisade Ave
1D
Yonkers, NY 10703-2651

Mailing address

420 Palisade Ave
1D
Yonkers, NY 10703-2651
Phone (914) 338-6857

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
008787-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1174077689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PALISADE AVE",
            "address_2": "1D",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107032651",
            "telephone_number": "914-338-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PALISADE AVE",
            "address_2": "1D",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107032651",
            "telephone_number": "914-338-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ADANA",
        "middle_name": "NIKKIA",
        "credential": "C.O.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "008787-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.