Individual provider Active NPI

Amber Nicole Nelson, COTA/L

  • Occupational Therapy Assistant
  • Dunbar, WV
National Provider Identifier
1386948545
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
C1779 Issued in WV
Practice address
505 Caldwell LN
Dunbar, WV 25064-2026
Phone
(304) 444-8466
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X C1779 WV Primary

Addresses

Primary practice location

505 Caldwell LN
Dunbar, WV 25064-2026

Mailing address

505 Caldwell LN
Dunbar, WV 25064-2026
Phone (304) 444-8466

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

LicenseStateTypeSpecialty
C1779WVMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1386948545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CALDWELL LN",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250642026",
            "telephone_number": "304-444-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CALDWELL LN",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250642026",
            "telephone_number": "304-444-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WV",
            "license": "C1779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunbar, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.