Individual provider Active NPI

Theresa Peterson, COTA/L

  • Occupational Therapy Assistant
  • Fairlawn, OH
National Provider Identifier
1376454934
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA009005 Issued in OH
Practice address
150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713
Phone
(330) 867-2240
NPI assigned
Sep 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OH3629105 OH
Occupational Therapy Assistant 224Z00000X OTA009005 OH Primary

Addresses

Primary practice location

150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713

Mailing address

150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713
Phone (330) 867-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1376454934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N MILLER RD STE 150A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333713",
            "telephone_number": "330-867-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MILLER RD STE 150A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333713",
            "telephone_number": "330-867-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THERESA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OH3629105",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA009005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.