Individual provider Active NPI

Ashley Chancey, COTA/L

  • Occupational Therapy Assistant
  • Broken Arrow, OK
National Provider Identifier
1174288229
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2363 Issued in OK
Practice address
2033 W Houston St
Broken Arrow, OK 74012-8304
Phone
(918) 994-7799
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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 2363 OK Primary

Addresses

Primary practice location

2033 W Houston St
Broken Arrow, OK 74012-8304

Mailing address

1688 S Sycamore Ave
Broken Arrow, OK 74012-5147
Phone (918) 810-5914

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
2363OKMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1174288229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 S SYCAMORE AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125147",
            "telephone_number": "918-810-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128304",
            "telephone_number": "918-994-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCEY",
        "first_name": "ASHLEY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.