Individual provider Active NPI

Tiffany C McGown, COTA

  • Occupational Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1487874806
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32001243A Issued in IN
Practice address
11077 State Road 3 Apt 112
Fort Wayne, IN 46818-0236
Phone
(260) 446-5179
NPI assigned
Apr 26, 2007
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32001243A IN Primary
Occupational Therapy Assistant 224Z00000X OTA 10375 FL
Occupational Therapy Assistant 224Z00000X OTA 03454 OH

Addresses

Primary practice location

11077 State Road 3 Apt 112
Fort Wayne, IN 46818-0236

Mailing address

11077 State Road 3 Apt 112
Fort Wayne, IN 46818-0236
Phone (260) 446-5179

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
OTA 10375FLMDOccupational Therapy Assistant
32001243AINMDOccupational Therapy Assistant
OTA 03454OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1487874806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11077 STATE ROAD 3 APT 112",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468180236",
            "telephone_number": "260-446-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11077 STATE ROAD 3 APT 112",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468180236",
            "telephone_number": "260-446-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWN",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001243A",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 10375",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA 03454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.