Active NPI
OT Integrated Health, LLC
- Occupational Therapist
- Davenport, IA
National Provider Identifier
1174943922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 00835
- Legal business name
- OT INTEGRATED HEALTH, LLC
- Practice address
- 2206 E 52ND St Ste a
Davenport, IA 52807-2790 - Phone
- (563) 355-7411
- Fax
- (563) 355-7431
- NPI assigned
- Apr 21, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammy R Conner
- Title
- President
- Phone
- (563) 355-7411
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 00835 | IA | Primary |
Addresses
Primary practice location
2206 E 52ND St Ste a
Davenport, IA 52807-2790
Mailing address
2206 E 52ND St Ste a
Davenport, IA 52807-2790
Phone (563) 355-7411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00835 | Other | IA | IOWA LICENSE |
National Provider Directory
National Provider DirectoryLocations
2206 E 52nd St
Ste A
Davenport, IA 52807
Phone (563) 340-8979
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Davenport, IA
- NPI 1255327425
-
- Chiropractor
- Bettendorf, IA
- NPI 1609079128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1398038400000",
"number": "1174943922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2206 E 52ND ST STE A",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072790",
"telephone_number": "563-355-7411",
"fax_number": "563-355-7431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 E 52ND ST STE A",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072790",
"telephone_number": "563-355-7411",
"fax_number": "563-355-7431"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OT INTEGRATED HEALTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A",
"authorized_official_last_name": "CONNER",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "563-355-7411"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "IA",
"license": "00835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA LICENSE",
"identifier": "00835",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.