Individual provider Active NPI

Amber Marie Simmons

  • Occupational Therapy Assistant
  • West Des Moines, IA
National Provider Identifier
1265615736
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
00613 Issued in IA
Practice address
1454 30TH St
Suite 103
West Des Moines, IA 50266-1305
Phone
(515) 223-6620
Fax
(515) 223-9625
NPI assigned
Dec 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 00613 IA Primary

Addresses

Primary practice location

1454 30TH St
Suite 103
West Des Moines, IA 50266-1305

Mailing address

1454 30TH St
Suite 103
West Des Moines, IA 50266-1305
Phone (515) 223-6620

Other identifiers 1

IdentifierTypeStateIssuer
0665190MedicaidIA

Other names 1

  • Amber Marie Bockenstedt Former name

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
00613IAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1265615736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 30TH ST",
            "address_2": "SUITE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661305",
            "telephone_number": "515-223-6620",
            "fax_number": "515-223-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 30TH ST",
            "address_2": "SUITE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661305",
            "telephone_number": "515-223-6620",
            "fax_number": "515-223-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IA",
            "license": "00613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665190",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "BOCKENSTEDT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.