Active NPI
Aaron Bryce Fuller, COTA
- Occupational Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1265815575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5360
- Practice address
- 8008 S Jesse Owens Pkwy
Phoenix, AZ 85042-6516 - Phone
- (602) 243-2780
- Fax
- (602) 243-7079
- NPI assigned
- Jul 6, 2015
- 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 Therapy Assistant | 224Z00000X | 5360 | AZ | Primary |
Addresses
Primary practice location
8008 S Jesse Owens Pkwy
Phoenix, AZ 85042-6516
Mailing address
4432 E Douglas Ave
Gilbert, AZ 85234-7409
Phone (480) 272-6215
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 |
|---|---|---|---|
| 5360 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1265815575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4432 E DOUGLAS AVE",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852347409",
"telephone_number": "480-272-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8008 S JESSE OWENS PKWY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850426516",
"telephone_number": "602-243-2780",
"fax_number": "602-243-7079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "AARON",
"middle_name": "BRYCE",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-06",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "5360",
"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 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.