Individual provider Active NPI

Christian Brown, O.T.A.

  • Occupational Therapy Assistant
  • Terre Haute, IN
National Provider Identifier
1285173575
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32002795A Issued in IN
Practice address
500 College Ave
Terre Haute, IN 47802-1139
Phone
(812) 917-2320
NPI assigned
Feb 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32002795A IN Primary

Addresses

Primary practice location

500 College Ave
Terre Haute, IN 47802-1139

Mailing address

2875 Spruce St
Indianapolis, IN 46203-5374
Phone (317) 418-8796

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

LicenseStateTypeSpecialty
32002795AINMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Past Accepting new patients
Legacy Healthcare Services Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1285173575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 SPRUCE ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462035374",
            "telephone_number": "317-418-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLLEGE AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478021139",
            "telephone_number": "812-917-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHRISTIAN",
        "credential": "O.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002795A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.