Amber Flavin, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057003428 Issued in IL

Practice address

550 S Mulford Rd
Rockford, IL 61108-2511

Phone

(815) 399-4989

NPI assigned

Oct 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1407284805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082511",
            "telephone_number": "815-399-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082511",
            "telephone_number": "815-399-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAVIN",
        "first_name": "AMBER",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057003428",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "488727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Fitzgerald
• Julie Fitzgerald, CCC-SLP
• Five Star Quality Care-Il, LLC
• Dennis Joseph Flanagan, D.D.S.,M.S.
• Samantha Marie Flannery, M.S.
• Megan Elizabeth Fleischman, PHARMD
• Andrew Fleming, PT
• Sara Fleming, MD
• Jeanne Marie Flesch, LCSW
• Carrie Elaine Flock, RN, MSN

• Occupational Therapy Assistant in Rockford, IL
• Providers in Rockford, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.