Individual provider Active NPI

Theodore W Fehr, O.T.

  • Occupational Therapist
  • Santa Ana, CA
National Provider Identifier
1376635326
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 6216 Issued in CA
Practice address
2700 N Main St Ste 340
Santa Ana, CA 92705-6638
Phone
(714) 953-7330
Fax
(949) 727-2193
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 OT 6216 CA Primary

Addresses

Primary practice location

2700 N Main St Ste 340
Santa Ana, CA 92705-6638

Mailing address

5905 Severin Dr
La Mesa, CA 91942-3806
Phone (619) 589-2606

Other identifiers 1

IdentifierTypeStateIssuer
CH719ZOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000876 CA Practitioner - Occupational Therapist in Private Practice 3870533813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18522 US Hwy 18
Suite 105
Apple Valley, CA 92307-2321
Phone (714) 244-7604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 6216CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services CurrentSince Aug 17, 2009 Accepting new patients
Advanced Hand Therapy, Inc CurrentSince Jan 22, 2019 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Past Accepting new patients
Eggleton Langton Physical Therapy Management Services Past Accepting new patients

Locations

18522 US Highway 18
Ste 105
Apple Valley, CA 92307
Phone (714) 244-7604

317 N El Camino Real
Ste 210
Encinitas, CA 92024
Phone (760) 337-1144

5905 Severin Dr
La Mesa, CA 91942
Phone (619) 589-2606

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1376635326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SEVERIN DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423806",
            "telephone_number": "619-589-2606",
            "fax_number": "619-464-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N MAIN ST STE 340",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056638",
            "telephone_number": "714-953-7330",
            "fax_number": "949-727-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHR",
        "first_name": "THEODORE",
        "middle_name": "W",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 6216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CH719Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.