Individual provider Active NPI

Amy P O'Bryan, OTR/L

  • Occupational Therapist
  • Louisville, KY
National Provider Identifier
1366821753
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
R1524 Issued in KY
Practice address
159 Saint Matthews Ave Ste 10
Louisville, KY 40207-3137
Phone
(502) 899-7105
Fax
(502) 899-1403
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X R1524 KY Primary

Addresses

Primary practice location

159 Saint Matthews Ave Ste 10
Louisville, KY 40207-3137

Mailing address

1715 Griffin Gate Rd
Louisville, KY 40205-2739
Phone (502) 417-1092

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R1524KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1366821753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 GRIFFIN GATE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052739",
            "telephone_number": "502-417-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 SAINT MATTHEWS AVE STE 10",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073137",
            "telephone_number": "502-899-7105",
            "fax_number": "502-899-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "AMY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R1524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.