Individual provider Active NPI

Tanae Kartak, OTR/L

  • Occupational Therapist
  • Gregory, SD
National Provider Identifier
1487176202
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1094 Issued in SD
Practice address
400 Park Ave
Gregory, SD 57533-1302
Phone
(605) 835-5190
NPI assigned
Jul 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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 1094 SD Primary

Addresses

Primary practice location

400 Park Ave
Gregory, SD 57533-1302

Mailing address

400 Park Ave
Gregory, SD 57533-1302

Other names 1

  • Tanae Novotny Former name

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
1094SDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1487176202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PARK AVE",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "575331302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARK AVE",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "575331302",
            "telephone_number": "605-835-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARTAK",
        "first_name": "TANAE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "1094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANAE",
            "last_name": "NOVOTNY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gregory, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.