Koushick Chakraborty, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT0000003621 Issued in TN

Practice address

3209 Bristol Hwy
Johnson City, TN 37601-1515

Phone

(423) 282-3311

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215036033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 VANLEER AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042306",
            "telephone_number": "423-434-2200",
            "fax_number": "423-434-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 BRISTOL HWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011515",
            "telephone_number": "423-282-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRABORTY",
        "first_name": "KOUSHICK",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT0000003621",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 5031",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1219",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004307",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "108485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Michaela Ceausu, MD
• Center for Applied Reproductive Science
• Chad E Johnson DDS PC
• Rebecca Chaffin, FNP
• Jenna Chafin
• Kayla Chambers, RD
• Marcus Antonio (Tony) Chambers, LPN
• Patricia L Chambers, M.D.
• Champion Physical Therapy LLC Halls
• Jessica Wei-Yee Chan, OD

• All providers in Johnson City, TN
• Occupational Therapist in Tennessee

• 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.

Verify at the official NPI Registry.