Individual provider Active NPI

Karen Rene Lockwood, COTA/L

  • Occupational Therapy Assistant
  • Weiser, ID
National Provider Identifier
1407018518
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-160 Issued in ID
Practice address
331 E Park St
Weiser, ID 83672-2053
Phone
(208) 549-2416
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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 OTA-160 ID Primary

Addresses

Primary practice location

331 E Park St
Weiser, ID 83672-2053

Mailing address

2553 Runway CT
Payette, ID 83661-2089
Phone (208) 642-0805

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
OTA-160IDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1407018518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 RUNWAY CT",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612089",
            "telephone_number": "208-642-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E PARK ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722053",
            "telephone_number": "208-549-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "KAREN",
        "middle_name": "RENE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "OTA-160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weiser, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.