Stephanie A Blunk, COTA/L

Key facts

NPI

1285961524

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

KY-A3142 (KY)

Practice address

3520 Sample Way
Louisville, KY 40245-7410

Phone

(502) 550-2525

NPI assigned

Nov 6, 2009

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 6, 2009.

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1285961524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CAMELLIA CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402296005",
            "telephone_number": "502-291-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 SAMPLE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402457410",
            "telephone_number": "502-550-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNK",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "KY-A3142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Louisville, KY · Occupational Therapy Assistant in Kentucky