Individual provider Active NPI

Lauren Nichole Grugen, COTA

  • Occupational Therapy Assistant
  • Louisville, KY
National Provider Identifier
1427423102
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
BOTOTA00223260 Issued in KY
Practice address
1909 Donald Dr
Louisville, KY 40216-1531
Phone
(502) 438-3447
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X BOTOTA00223260 KY Primary

Addresses

Primary practice location

1909 Donald Dr
Louisville, KY 40216-1531

Mailing address

1909 Donald Dr
Louisville, KY 40216-1531
Phone (502) 438-3447

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
BOTOTA00223260KYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1427423102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 DONALD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161531",
            "telephone_number": "502-438-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 DONALD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161531",
            "telephone_number": "502-438-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUGEN",
        "first_name": "LAUREN",
        "middle_name": "NICHOLE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "BOTOTA00223260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.