Nicole Green, OT
Individual provider Active NPI Occupational Therapist · Wheatland, IA
NPI 1346833258 · NPPES record last updated Feb 11, 2021
Key facts
- NPI
- 1346833258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 084101 (IA)
- Practice address
- 316 E Lincolnway St
Wheatland, IA 52777-9717 - Phone
- (563) 374-1295
- NPI assigned
- Feb 11, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084101 | IA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Therapy Services, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 084101 | IA | Yes |
Addresses
Primary practice location
316 E Lincolnway St
Wheatland, IA 52777-9717
Mailing address
812 4TH St
De Witt, IA 52742-1921
Phone (563) 210-8293
Other providers in Wheatland, IA
- David Anthony Blaber
- Mark Edward Kalarovich
- Patricia M. H. Kalarovich
- Maximum Wellness Center, Inc.
- Makenzie Mente
- Meghan Morrison
All providers in Wheatland, IA · Occupational Therapist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.