Individual provider Active NPI

Julianne Rutley, OTR

  • Occupational Therapist
  • Canton, NY
National Provider Identifier
1407139017
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009940-1 Issued in NY
Practice address
139 Outer State Street Rd
Canton, NY 13617
Phone
(315) 386-4504
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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 009940-1 NY Primary

Addresses

Primary practice location

139 Outer State Street Rd
Canton, NY 13617

Mailing address

8765 US Highway 11
Potsdam, NY 13676-3227
Phone (315) 265-0686

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
009940-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1407139017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 US HIGHWAY 11",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763227",
            "telephone_number": "315-265-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 OUTER STATE STREET RD",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "13617",
            "telephone_number": "315-386-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEY",
        "first_name": "JULIANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "009940-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.