Active NPI
Tara Ashlee Newberry, COTA
- Occupational Therapy Assistant
- Radford, VA
National Provider Identifier
1275704041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1046889
- Practice address
- 700 Randolph St
Radford, VA 24141-2430 - Phone
- (540) 633-3708
- NPI assigned
- Mar 19, 2008
- Last updated
- Mar 19, 2008
- 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 Therapy Assistant | 224Z00000X | 1046889 | VA | Primary |
Addresses
Primary practice location
700 Randolph St
Radford, VA 24141-2430
Mailing address
1407 Lakewood Dr
Pulaski, VA 24301-9318
Phone (540) 633-3708
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 |
|---|---|---|---|
| 1046889 | VA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1275704041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 LAKEWOOD DR",
"city": "PULASKI",
"state": "VA",
"postal_code": "243019318",
"telephone_number": "540-633-3708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 RANDOLPH ST",
"city": "RADFORD",
"state": "VA",
"postal_code": "241412430",
"telephone_number": "540-633-3708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "TARA",
"middle_name": "ASHLEE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "1046889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Radford, VA
- New River Mediccal Massage
- New River Physical Therapy
- New River Valley Hearing Inc
- New River Valley Orthodontics, PLLC
- New River Valley Rehab Services, PLLC
- Tony Hoang Nguyen, LAT, ATC
- Sarah Murphy Nightingale, PHARMD
- NRV Health Care LLC (Radford Health & Rehab Center)
- NRV Internal Medicine LLC (Sage Health)
- John F Ogburn III, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.