Individual provider Active NPI

Carlyn Knickelbein, COTA/L

  • Occupational Therapy Assistant
  • Denver, CO
National Provider Identifier
1316510423
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.0001473 Issued in CO
Practice address
7108 E Lowry Blvd Apt 2173
Denver, CO 80230-7027
Phone
(920) 427-8810
NPI assigned
Jul 19, 2021
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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 OTA.0001473 CO Primary

Addresses

Primary practice location

7108 E Lowry Blvd Apt 2173
Denver, CO 80230-7027

Mailing address

7108 E Lowry Blvd Apt 2173
Denver, CO 80230-7027
Phone (920) 427-8810

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
OTA.0001473COMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1316510423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 E LOWRY BLVD APT 2173",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307027",
            "telephone_number": "920-427-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 E LOWRY BLVD APT 2173",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307027",
            "telephone_number": "920-427-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKELBEIN",
        "first_name": "CARLYN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "OTA.0001473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.