Individual provider Active NPI

Miranda Rose Lipp, COTA/L

  • Occupational Therapy Assistant
  • Aurora, CO
National Provider Identifier
1184440547
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.0001839 Issued in CO
Practice address
3131 S Vaughn Way Ste 110
Aurora, CO 80014-3501
Phone
(303) 775-5534
NPI assigned
Dec 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 OTA.0001839 CO Primary

Addresses

Primary practice location

3131 S Vaughn Way Ste 110
Aurora, CO 80014-3501

Mailing address

2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666
Phone (515) 371-5185

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
OTA.0001839COMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1184440547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 ACADEMY PL STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091666",
            "telephone_number": "515-371-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S VAUGHN WAY STE 110",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800143501",
            "telephone_number": "303-775-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPP",
        "first_name": "MIRANDA",
        "middle_name": "ROSE",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "OTA.0001839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.