Active NPI
Brooke Sue Rupe, COTA/L
- Occupational Therapy Assistant
- Idaho Falls, ID
National Provider Identifier
1376213850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA-2264
- Practice address
- 1460 Elk Creek Dr
Idaho Falls, ID 83404-8237 - Phone
- (208) 535-1286
- NPI assigned
- Sep 16, 2021
- Sex
- Female
- Sole proprietor
- No
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 | OTA-2264 | ID | Primary |
Addresses
Primary practice location
1460 Elk Creek Dr
Idaho Falls, ID 83404-8237
Mailing address
2615 Rebel Rd
Ammon, ID 83406
Phone (208) 419-8894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA-2264 | Other | ID | STATE ISSUED LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | connectionstherapies.com |
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 |
|---|---|---|---|
| OTA-2264 | ID | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain View Hospital LLC | Past | Accepting new patients | |
| Speech and Language Clinic, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
-
- Speech-Language Pathologist
- Ammon, ID
- NPI 1891953519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1376213850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 REBEL RD",
"city": "AMMON",
"state": "ID",
"postal_code": "83406",
"telephone_number": "208-419-8894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 ELK CREEK DR",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834048237",
"telephone_number": "208-535-1286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPE",
"first_name": "BROOKE",
"middle_name": "SUE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-16",
"last_updated": "2021-09-16",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "ID",
"license": "OTA-2264",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE ISSUED LICENSE",
"identifier": "OTA-2264",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "connectionstherapies.com",
"affiliation": "N",
"address_1": "1460 Elk Creek Dr",
"city": "Idaho Falls",
"state": "ID",
"country_code": "US",
"postal_code": "834048237",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.