Active NPI
Aubrey Clement, COTA
- Occupational Therapy Assistant
- Palmer, AK
National Provider Identifier
1417701616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 12902298-4202
- Practice address
- 7200 E Jim Cottrell Circle
Palmer, AK 99645 - Phone
- (907) 982-3897
- NPI assigned
- Apr 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 12902298-4202 | UT | Primary |
Addresses
Primary practice location
7200 E Jim Cottrell Circle
Palmer, AK 99645
Mailing address
3590 E Elderberry LN
Kamas, UT 84036-4613
Phone (530) 807-7884
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12902298-4202 | UT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1417701616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3590 E ELDERBERRY LN",
"city": "KAMAS",
"state": "UT",
"postal_code": "840364613",
"telephone_number": "530-807-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 E JIM COTTRELL CIRCLE",
"city": "PALMER",
"state": "AK",
"postal_code": "99645",
"telephone_number": "907-982-3897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENT",
"first_name": "AUBREY",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-15",
"last_updated": "2024-04-15",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "UT",
"license": "12902298-4202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.