Amy Meredith Nitecki, OTR/L

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

Practice address

1582 W San Marcos Blvd Ste 105
San Marcos, CA 92078-4081

Phone

(650) 452-4110

NPI assigned

Oct 10, 2022

Last updated

Oct 10, 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

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1396460440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HARRELL DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587876",
            "telephone_number": "567-207-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1582 W SAN MARCOS BLVD STE 105",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784081",
            "telephone_number": "650-452-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITECKI",
        "first_name": "AMY",
        "middle_name": "MEREDITH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Twila A Noble, N.P.-C
• Robyn Lynn Nolta, LMFT
• Nordahl Dental Inc
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• Neurorehabilitation Occupational Therapist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Neurorehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.