Active NPI
Niklaas David Jules Allain, OT
- Occupational Therapist
- Fort Collins, CO
National Provider Identifier
1215910153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.0000570
- Practice address
- 2500 E Prospect Rd
Fort Collins, CO 80525-9718 - Phone
- (970) 493-0112
- NPI assigned
- Nov 23, 2005
- Last updated
- Oct 14, 2014
- Sex
- Male
- 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 Therapist | 225X00000X | OT.0000570 | CO | Primary |
Addresses
Primary practice location
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Mailing address
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119385600 | Medicaid | WY | |
| P00363678 | Other | CO | RR MEDICARE |
| 22009779 | Medicaid | CO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT.0000570 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413244800000",
"number": "1215910153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 E PROSPECT RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805259718",
"telephone_number": "970-493-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 E PROSPECT RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805259718",
"telephone_number": "970-493-0112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLAIN",
"first_name": "NIKLAAS",
"middle_name": "DAVID JULES",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2014-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "OT.0000570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119385600",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00363678",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22009779",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.