NPIMap

Organization Active NPI

Occupational Therapy Services

  • Rehabilitation Clinic/Center
  • Evanston, WY
National Provider Identifier
1255797007
Registry record updated Jan 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
OTR-509 Issued in WY
Legal business name
OCCUPATIONAL THERAPY SERVICES
Practice address
612 Country Club Dr
Evanston, WY 82930-3252
Phone
(307) 677-0669
NPI assigned
Jan 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2016

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

Authorized official

Name
Dr. Carol Diane Davis, OTR/LNPI 1437515285
Title
Occupational Therapist
Phone
(307) 677-0669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X OTR-509 WY Primary

Addresses

Primary practice location

612 Country Club Dr
Evanston, WY 82930-3252

Mailing address

612 Country Club Dr
Evanston, WY 82930-3252
Phone (307) 677-0669

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452297600000",
    "number": "1255797007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 COUNTRY CLUB DR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303252",
            "telephone_number": "307-677-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 COUNTRY CLUB DR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303252",
            "telephone_number": "307-677-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-09",
        "last_updated": "2016-01-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "307-677-0669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "WY",
            "license": "OTR-509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2016; 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.