Active NPI
Tyrone Factora, OT
- Occupational Therapist
- Bloomington, IN
National Provider Identifier
1376639955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003809A
- Practice address
- 2536 Industrial Dr
Ste 11
Bloomington, IN 47404 - Phone
- (812) 332-7529
- Fax
- (812) 339-7529
- NPI assigned
- Oct 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 Therapist | 225X00000X | 31003809A | IN | Primary |
Addresses
Primary practice location
2536 Industrial Dr
Ste 11
Bloomington, IN 47404
Mailing address
2536 Industrial Dr
Ste 11
Bloomington, IN 47404
Phone (812) 332-7529
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31003809A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theraplay LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376639955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2536 INDUSTRIAL DR",
"address_2": "STE 11",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47404",
"telephone_number": "812-332-7529",
"fax_number": "812-339-7529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2536 INDUSTRIAL DR",
"address_2": "STE 11",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47404",
"telephone_number": "812-332-7529",
"fax_number": "812-339-7529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FACTORA",
"first_name": "TYRONE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003809A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.