Mary Tedesko, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1018023 Issued in CO

Practice address

722 S 8TH St
Canon City, CO 81212-4906

Phone

(719) 345-4097

Fax

(719) 345-4098

NPI assigned

Oct 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Hudson Group Inc.

  • Physical Therapist
  • Canon City, CO
  • NPI 1871824748
  NPD (past)

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1215280235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "81212",
            "telephone_number": "719-345-4097",
            "fax_number": "719-345-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-345-4097",
            "fax_number": "719-345-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESKO",
        "first_name": "MARY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "1018023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED OCCUPATIONAL THERAPY ASSISTANT",
            "identifier": "1018023",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Swonson
• Angela Kimberly Szramka, LMT
• Christina Tafoya
• Tenisha D Tavares, RD
• Laura Kristie Taylor
• Debbie Tedrow, BS
• Colette Textor, RN
• The Hudson Group Inc.
• The Speech Garden LLC
• Thomas J McGuire MD

• Occupational Therapy Assistant in Canon City, CO
• Providers in Canon City, CO by specialty
• Occupational Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.