Active NPI
Winnie L Tarter, COTA/L
- Occupational Therapy Assistant
- Fairdale, KY
National Provider Identifier
1336651934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 161877
- Practice address
- 616 Drummond Way
Fairdale, KY 40118-9632 - Phone
- (502) 492-9452
- NPI assigned
- Nov 4, 2017
- 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 | 161877 | KY | Primary |
Addresses
Primary practice location
616 Drummond Way
Fairdale, KY 40118-9632
Mailing address
616 Drummond Way
Fairdale, KY 40118-9632
Phone (502) 414-1707
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 |
|---|---|---|---|
| 161877 | KY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509753600000",
"number": "1336651934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 DRUMMOND WAY",
"city": "FAIRDALE",
"state": "KY",
"postal_code": "401189632",
"telephone_number": "502-414-1707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 DRUMMOND WAY",
"city": "FAIRDALE",
"state": "KY",
"postal_code": "401189632",
"telephone_number": "502-492-9452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARTER",
"first_name": "WINNIE",
"middle_name": "L",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-04",
"last_updated": "2017-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "KY",
"license": "161877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairdale, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.