Samantha Jane McCollom, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32002736A Issued in IN

Practice address

712 W 2ND St
Leavenworth, IN 47137-2264

Phone

(812) 739-2292

NPI assigned

Oct 21, 2014

Last updated

Oct 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1285038190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 W 2ND ST",
            "city": "LEAVENWORTH",
            "state": "IN",
            "postal_code": "471372264",
            "telephone_number": "812-739-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 W 2ND ST",
            "city": "LEAVENWORTH",
            "state": "IN",
            "postal_code": "471372264",
            "telephone_number": "812-739-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOM",
        "first_name": "SAMANTHA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002736A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Claire McMillan, M.S. CCC-SLP
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• Abigail Preher, OT
• Erica Pulce-Perry, PT
• Kasie D Reed, PTA

• Occupational Therapy Assistant in Leavenworth, IN
• Providers in Leavenworth, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.