Carson Elise Bailey, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

3826 Issued in TN

Practice address

14510 Highway 79
MC Kenzie, TN 38201-7824

Phone

(731) 352-5317

Fax

(731) 352-5942

NPI assigned

Jun 20, 2022

Last updated

Jun 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carson Elise Hatch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1386375400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HIGH ST",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383443206",
            "telephone_number": "731-499-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14510 HIGHWAY 79",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382017824",
            "telephone_number": "731-352-5317",
            "fax_number": "731-352-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "CARSON",
        "middle_name": "ELISE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "3826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARSON",
            "last_name": "HATCH",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavioral Health and Wellness
• Bethel Universtiy

• Occupational Therapy Assistant in McKenzie, TN
• Providers in McKenzie, TN by specialty
• Occupational Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.