Active NPI
Joanne Enriquez, COTA
- Occupational Therapy Assistant
- Farmington, NM
National Provider Identifier
1316230691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2700
- Practice address
- 806 W Maple St
Farmington, NM 87401-5631 - Phone
- (505) 325-2910
- Fax
- (505) 325-0191
- NPI assigned
- May 19, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2700 | NM | Primary |
Addresses
Primary practice location
806 W Maple St
Farmington, NM 87401-5631
Mailing address
1612 S. Santa Cruz St.
Deming, NM 88030-0000
Phone (515) 545-3831
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 |
|---|---|---|---|
| 2700 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1316230691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1612 S. SANTA CRUZ ST.",
"city": "DEMING",
"state": "NM",
"postal_code": "880300000",
"telephone_number": "515-545-3831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 W MAPLE ST",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015631",
"telephone_number": "505-325-2910",
"fax_number": "505-325-0191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENRIQUEZ",
"first_name": "JOANNE",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-19",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "2700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.