Individual provider Active NPI

Gale Edward Horn III, OTA

  • Occupational Therapy Assistant
  • Tahlequah, OK
National Provider Identifier
1396408944
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2361 Issued in OK
Practice address
3475 Southridge PL Apt 9
Tahlequah, OK 74464-7913
Phone
(918) 316-5429
NPI assigned
Oct 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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 2361 OK Primary

Addresses

Primary practice location

3475 Southridge PL Apt 9
Tahlequah, OK 74464-7913

Mailing address

3475 Southridge PL Apt 9
Tahlequah, OK 74464-7913
Phone (918) 316-5429

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Tahlequah

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1396408944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 SOUTHRIDGE PL APT 9",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647913",
            "telephone_number": "918-316-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 SOUTHRIDGE PL APT 9",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647913",
            "telephone_number": "918-316-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "GALE",
        "middle_name": "EDWARD",
        "name_suffix": "III",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tahlequah",
            "affiliation": "N",
            "address_1": "3475 Southridge Pl Apt 9",
            "city": "Tahlequah",
            "state": "OK",
            "country_code": "US",
            "postal_code": "744647913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.