Active NPI
Kristy Ann Deeter, OTRL
- Occupational Therapist
- Phoenix, AZ
National Provider Identifier
1265637102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC007300L
- Practice address
- 7540 N 19TH Ave
Phoenix, AZ 85021-7967 - Phone
- (888) 873-4221
- Fax
- (888) 543-2289
- NPI assigned
- Jun 20, 2007
- Sex
- Female
- 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 | OC007300L | PA | Primary |
Addresses
Primary practice location
7540 N 19TH Ave
Phoenix, AZ 85021-7967
Mailing address
523 Maple Ave
Tower City, PA 17980
Phone (717) 647-0427
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC007300L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265637102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 MAPLE AVE",
"city": "TOWER CITY",
"state": "PA",
"postal_code": "17980",
"telephone_number": "717-647-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7540 N 19TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217967",
"telephone_number": "888-873-4221",
"fax_number": "888-543-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEETER",
"first_name": "KRISTY",
"middle_name": "ANN",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC007300L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- 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.