Active NPI
Gwen Marie Kooi, OTR
- Pediatric Occupational Therapist
- Tucson, AZ
National Provider Identifier
1285755058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 215
- Practice address
- 1010 E 10TH St
Tucson, AZ 85719-5813 - Phone
- (520) 225-6410
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 215 | AZ | Primary |
Addresses
Primary practice location
1010 E 10TH St
Tucson, AZ 85719-5813
Mailing address
8342 E Sandstone Dr
Tucson, AZ 85750-9783
Phone (520) 749-2052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068204 | Medicaid | AZ |
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 |
|---|---|---|---|
| 215 | AZ | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285755058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8342 E SANDSTONE DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857509783",
"telephone_number": "520-749-2052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 E 10TH ST",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857195813",
"telephone_number": "520-225-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOI",
"first_name": "GWEN",
"middle_name": "MARIE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AZ",
"license": "215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "068204",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.