Active NPI
Amirra Condelee, OTD, OTR/L
- Pediatric Occupational Therapist
- Scottsdale, AZ
National Provider Identifier
1295381952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTH-007901
- Practice address
- 10049 E Dynamite Blvd Ste 110
Scottsdale, AZ 85262-3694 - Phone
- (480) 419-0848
- NPI assigned
- Aug 16, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTH-007901 | NC | Primary |
Addresses
Primary practice location
10049 E Dynamite Blvd Ste 110
Scottsdale, AZ 85262-3694
Mailing address
11 S Central Ave Apt 1401
Phoenix, AZ 85004-2596
Phone (191) 922-5997
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-007901 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamite Therapy, LLC | Current | Accepting new patients |
Locations
10049 E Dynamite Blvd
Ste 110
Scottsdale, AZ 85262
Phone (480) 419-0848
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.
-
- Home Health Agency
- Scottsdale, AZ
- NPI 1730388828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1295381952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 S CENTRAL AVE APT 1401",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850042596",
"telephone_number": "191-922-5997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10049 E DYNAMITE BLVD STE 110",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852623694",
"telephone_number": "480-419-0848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDELEE",
"first_name": "AMIRRA",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-16",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NC",
"license": "OTH-007901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.