Individual provider Active NPI

Naomi Dawn Deaton, COTA/L

  • Occupational Therapy Assistant
  • Poplar Bluff, MO
National Provider Identifier
1376350553
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2014002461 Issued in MO
Practice address
2154 J Bird LN
Poplar Bluff, MO 63901-8326
Phone
(573) 714-8897
NPI assigned
Dec 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2014002461 MO Primary

Addresses

Primary practice location

2154 J Bird LN
Poplar Bluff, MO 63901-8326

Mailing address

2154 J Bird LN
Poplar Bluff, MO 63901-8326
Phone (573) 714-8897

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
2014002461MOMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1376350553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 J BIRD LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018326",
            "telephone_number": "573-714-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 J BIRD LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018326",
            "telephone_number": "573-714-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATON",
        "first_name": "NAOMI",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2014002461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.