Individual provider Active NPI

Andrea Cheatham, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1215026240
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
012653-1 Issued in NY
Practice address
1779 2ND Ave
Apt. 12C
New York, NY 10128-3613
Phone
(917) 414-5075
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 012653-1 NY Primary

Addresses

Primary practice location

1779 2ND Ave
Apt. 12C
New York, NY 10128-3613

Mailing address

1779 2ND Ave
Apt. 12C
New York, NY 10128-3613
Phone (917) 414-5075

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
012653-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1215026240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 2ND AVE",
            "address_2": "APT. 12C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283613",
            "telephone_number": "917-414-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 2ND AVE",
            "address_2": "APT. 12C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283613",
            "telephone_number": "917-414-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012653-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.