Active NPI
Riena M Duggan, COTA
- Occupational Therapy Assistant
- Pueblo, CO
National Provider Identifier
1194077552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1077018
- Practice address
- 1339 Cypress St
Pueblo, CO 81004-3130 - Phone
- (710) 320-9811
- NPI assigned
- Oct 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 1077018 | CO | Primary |
Addresses
Primary practice location
1339 Cypress St
Pueblo, CO 81004-3130
Mailing address
1339 Cypress St.
Pueblo, CO 81004
Phone (710) 320-9811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1077018 | Other | CO | MEDICARE |
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 |
|---|---|---|---|
| 1077018 | CO | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1194077552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1339 CYPRESS ST.",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81004",
"telephone_number": "710-320-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1339 CYPRESS ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810043130",
"telephone_number": "710-320-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGGAN",
"first_name": "RIENA",
"middle_name": "M",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-10",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CO",
"license": "1077018",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "1077018",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.