Individual provider Active NPI

Fallon Fitzsimons, MS, OTR

  • Occupational Therapist
  • Greenwood, IN
National Provider Identifier
1417352170
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31005585A Issued in IN
Practice address
1411 W County Line Rd
Greenwood, IN 46142
Phone
(317) 886-5010
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 31005585A IN Primary

Addresses

Primary practice location

1411 W County Line Rd
Greenwood, IN 46142

Mailing address

1411 W County Line Rd
Greenwood, IN 46142
Phone (317) 886-5010

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
31005585AINMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1417352170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46142",
            "telephone_number": "317-886-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46142",
            "telephone_number": "317-886-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMONS",
        "first_name": "FALLON",
        "credential": "MS, OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005585A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.