Active NPI
Sara Mallams, MS OTR/L
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1285022046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6234-26
- Practice address
- 7305 Nantucket CT
1A
Indianapolis, IN 46214-1294 - Phone
- (715) 853-5753
- NPI assigned
- Jan 2, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31005738A | IN | |
| Occupational Therapist | 225X00000X | 075376 | IA | |
| Occupational Therapist | 225X00000X | 6234-26 | WI | Primary |
Addresses
Primary practice location
7305 Nantucket CT
1A
Indianapolis, IN 46214-1294
Mailing address
1436 S. Lincoln St.
Shawano, WI 54166
Phone (715) 526-6111
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075376 | IA | MD | Occupational Therapist |
| 31005738A | IN | MD | Occupational Therapist |
| 6234-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shawano Health Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Skilled Nursing Facility
- Shawano, WI
- NPI 1013386614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1285022046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1436 S. LINCOLN ST.",
"city": "SHAWANO",
"state": "WI",
"postal_code": "54166",
"telephone_number": "715-526-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7305 NANTUCKET CT",
"address_2": "1A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462141294",
"telephone_number": "715-853-5753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLAMS",
"first_name": "SARA",
"name_prefix": "Mrs.",
"credential": "MS OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-02",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005738A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "075376",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6234-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.