Active NPI
Roberta Davis, COTA
- Occupational Therapy Assistant
- Bedford, OH
National Provider Identifier
1184843203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA-00689
- Practice address
- 127 Garden St
Bedford, OH 44146-2752 - Phone
- (440) 346-6127
- NPI assigned
- Apr 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA-00689 | OH | Primary |
Addresses
Primary practice location
127 Garden St
Bedford, OH 44146-2752
Mailing address
127 Garden St
Bedford, OH 44146-2752
Phone (440) 346-6127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA-00689 | Other | OH | OCCUPATIONAL THERAPIST AS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA-00689 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184843203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 GARDEN ST",
"city": "BEDFORD",
"state": "OH",
"postal_code": "441462752",
"telephone_number": "440-346-6127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 GARDEN ST",
"city": "BEDFORD",
"state": "OH",
"postal_code": "441462752",
"telephone_number": "440-346-6127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ROBERTA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA-00689",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPIST AS",
"identifier": "OTA-00689",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bedford, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.