Individual provider Active NPI

Karen Stella Williams, C.O.T.A.

  • Occupational Therapy Assistant
  • Brookings, OR
National Provider Identifier
1356672653
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1031820 Issued in OR
Practice address
1 Park Avenue
Brookings, OR 97415-0217
Phone
(541) 469-3111
Fax
(541) 469-5970
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1031820 OR Primary
Occupational Therapy Assistant 224Z00000X OTA426 CA
Occupational Therapy Assistant 224Z00000X OC60067631 WA

Addresses

Primary practice location

1 Park Avenue
Brookings, OR 97415-0217

Mailing address

97450 N. 19TH Ave
Suite 200
Phoenix, AZ 85021-7967
Phone (602) 324-6500

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
OTA426CAMDOccupational Therapy Assistant
1031820ORMDOccupational Therapy Assistant
OC60067631WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1356672653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97450 N. 19TH AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "602-324-6500",
            "fax_number": "602-324-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVENUE",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974150217",
            "telephone_number": "541-469-3111",
            "fax_number": "541-469-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KAREN",
        "middle_name": "STELLA",
        "name_prefix": "Ms.",
        "credential": "C.O.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OR",
            "license": "1031820",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA426",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60067631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.