Individual provider Active NPI

Edna Palispis

  • Occupational Therapist
  • Bowling Green, KY
National Provider Identifier
1407053473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
KY-R3123 Issued in KY
Practice address
1561 Newton Ave
Bowling Green, KY 42104-3238
Phone
(270) 842-1611
Fax
(270) 842-3858
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X KY-R3123 KY Primary

Addresses

Primary practice location

1561 Newton Ave
Bowling Green, KY 42104-3238

Mailing address

959 Morgantown Rd Apt 34
Bowling Green, KY 42101-9068

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-R3123KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Support Healthcare Services LLC Past Accepting new patients
Acadia Healthcare Services LLC Past Accepting new patients

Organizations & group practices 2

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407053473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 MORGANTOWN RD APT 34",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421019068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 NEWTON AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043238",
            "telephone_number": "270-842-1611",
            "fax_number": "270-842-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALISPIS",
        "first_name": "EDNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "KY-R3123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.