NPIMap

Individual provider Active NPI

Taryn H Dubose, OT, CHT, QMHP

  • Occupational Therapist
  • Bend, OR
National Provider Identifier
1437188588
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1066420 Issued in OR
Practice address
223 SE Davis Ave
Bend, OR 97702-1333
Phone
(541) 797-3638
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT00003738 WA
Mental Health Occupational Therapist 225XM0800X 1066420 OR
Occupational Therapist 225X00000X 1066420 OR Primary
Hand Occupational Therapist 225XH1200X 1066420 OR

Addresses

Primary practice location

223 SE Davis Ave
Bend, OR 97702-1333

Mailing address

223 SE Davis Ave Ste 3
Bend, OR 97702-1333
Phone (541) 797-3638

Other identifiers 1

IdentifierTypeStateIssuer
500642902MedicaidOR

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

State licenses

LicenseStateTypeSpecialty
1066420ORMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Rehabilitation Associates, PLLC Occupational Therapist Past Accepting new patients
Therapeutic Associates Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1437188588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 SE DAVIS AVE STE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021333",
            "telephone_number": "541-797-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 SE DAVIS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021333",
            "telephone_number": "541-797-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "TARYN",
        "middle_name": "H",
        "credential": "OT, CHT, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003738",
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "OR",
            "license": "1066420",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1066420",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "1066420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642902",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.