Active NPI
Carly Anne Herrick, OTR/L
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1447624945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 105015
- Practice address
- 13609 California St
Omaha, NE 68154-5260 - Phone
- (402) 891-1118
- NPI assigned
- Nov 20, 2015
- 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 Therapist | 225X00000X | 105015 | MN | Primary |
Addresses
Primary practice location
13609 California St
Omaha, NE 68154-5260
Mailing address
11375 Hill N Dale Dr
Minocqua, WI 54548-9517
Phone (715) 301-6397
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447977600000",
"number": "1447624945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11375 HILL N DALE DR",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "545489517",
"telephone_number": "715-301-6397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13609 CALIFORNIA ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545260",
"telephone_number": "402-891-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRICK",
"first_name": "CARLY",
"middle_name": "ANNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-20",
"last_updated": "2015-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "105015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.