Individual provider Active NPI

Austen Lincoln, OTR/L

  • Pediatric Occupational Therapist
  • Portland, OR
National Provider Identifier
1336555119
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
288785 Issued in OR
Practice address
2870 NW Cornell Rd
Portland, OR 97210-2421
Phone
(503) 720-4634
Fax
(844) 250-7399
NPI assigned
Jul 1, 2014
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13722 NC
Pediatric Occupational Therapist 225XP0200X 60563617 WA
Pediatric Occupational Therapist 225XP0200X 288785 OR Primary

Addresses

Primary practice location

2870 NW Cornell Rd
Portland, OR 97210-2421

Mailing address

2870 NW Cornell Rd
Portland, OR 97210-2421
Phone (503) 720-4634

Other practice location 1

5222 Nc Highway 16 S
Moravian Falls, NC 28654-9144
Phone (503) 720-4634

Other names 1

  • Austen Taylor Former name

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
13722NCMDOccupational Therapist
288785ORMDPediatric Occupational Therapist
60563617WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Steps 2 Grow LLC Pediatrics CurrentSince Nov 15, 2020 Accepting new patients
Mindful Movement Therapies LLC Pediatrics PastSince Oct 20, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1336555119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102421",
            "telephone_number": "503-720-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102421",
            "telephone_number": "503-720-4634",
            "fax_number": "844-250-7399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5222 Nc Highway 16 S",
            "address_purpose": "LOCATION",
            "city": "Moravian Falls",
            "state": "NC",
            "postal_code": "286549144",
            "country_code": "US",
            "telephone_number": "503-720-4634",
            "fax_number": "844-250-7399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "AUSTEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "13722",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "60563617",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "288785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUSTEN",
            "last_name": "TAYLOR",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.