Individual provider Active NPI

Kathryn Marion, COTA/L

  • Occupational Therapy Assistant
  • Prescott, AZ
National Provider Identifier
1184475600
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-050008 Issued in AZ
Practice address
3160 Stillwater Dr
Prescott, AZ 86305-7151
Phone
(805) 231-2507
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 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-050008 AZ Primary

Addresses

Primary practice location

3160 Stillwater Dr
Prescott, AZ 86305-7151

Mailing address

1241 Louie St
Prescott, AZ 86301-7604
Phone (805) 231-2507

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-050008AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1184475600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 LOUIE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863017604",
            "telephone_number": "805-231-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 STILLWATER DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057151",
            "telephone_number": "805-231-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARION",
        "first_name": "KATHRYN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-050008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.