Active NPI
Amber Dawn Taylor
- Occupational Therapy Assistant
- Crescent, OK
National Provider Identifier
1356965628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 708
- Practice address
- 11150 Wolf Creek Dr
Crescent, OK 73028-9350 - Phone
- (405) 740-1367
- NPI assigned
- Jun 2, 2020
- 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 | 708 | OK | Primary |
Addresses
Primary practice location
11150 Wolf Creek Dr
Crescent, OK 73028-9350
Mailing address
11150 Wolf Creek Dr
Crescent, OK 73028-9350
Phone (405) 740-1367
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 |
|---|---|---|---|
| 708 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1356965628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11150 WOLF CREEK DR",
"city": "CRESCENT",
"state": "OK",
"postal_code": "730289350",
"telephone_number": "405-740-1367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11150 WOLF CREEK DR",
"city": "CRESCENT",
"state": "OK",
"postal_code": "730289350",
"telephone_number": "405-740-1367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "AMBER",
"middle_name": "DAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-02",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.