Active NPI
Patricia Sue Halleran, OTRL
- Occupational Therapist
- Ankeny, IA
National Provider Identifier
1376663518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01165
- Practice address
- 301 NE Trilein Dr Ste 4
Ankeny, IA 50021-2170 - Phone
- (319) 366-8714
- NPI assigned
- Mar 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 01165 | IA | Primary |
Addresses
Primary practice location
301 NE Trilein Dr Ste 4
Ankeny, IA 50021-2170
Mailing address
371 Prairie View Cir
Fairfax, IA 52228-9504
Phone (319) 845-4033
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 |
|---|---|---|---|
| 01165 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376663518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 PRAIRIE VIEW CIR",
"city": "FAIRFAX",
"state": "IA",
"postal_code": "522289504",
"telephone_number": "319-845-4033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 NE TRILEIN DR STE 4",
"city": "ANKENY",
"state": "IA",
"postal_code": "500212170",
"telephone_number": "319-366-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLERAN",
"first_name": "PATRICIA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "01165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ankeny, IA
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.