Tod Garrett Faris, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

110097 Issued in IA

Practice address

2455 SW State St Ste 105
Ankeny, IA 50023-1277

Phone

(515) 963-4528

NPI assigned

Aug 4, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1316611304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 NW BUCKINGHAM LN UNIT 213",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500230040",
            "telephone_number": "641-856-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 SW STATE ST STE 105",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231277",
            "telephone_number": "515-963-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIS",
        "first_name": "TOD",
        "middle_name": "GARRETT",
        "name_prefix": "Mr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IA",
            "license": "110097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Pediatric Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.