Individual provider Active NPI

Faith Provost Harding, COTA

  • Occupational Therapy Assistant
  • Newark, NY
National Provider Identifier
1497886600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0017811 Issued in NY
Practice address
150 Van Buren St
Newark, NY 14513-1238
Phone
(315) 331-7741
Fax
(315) 331-0566
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0017811 NY Primary

Addresses

Primary practice location

150 Van Buren St
Newark, NY 14513-1238

Mailing address

5419 Russell Rd
Marion, NY 14505-9357
Phone (315) 589-9236

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
0017811NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497886600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 RUSSELL RD",
            "city": "MARION",
            "state": "NY",
            "postal_code": "145059357",
            "telephone_number": "315-589-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VAN BUREN ST",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131238",
            "telephone_number": "315-331-7741",
            "fax_number": "315-331-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDING",
        "first_name": "FAITH",
        "middle_name": "PROVOST",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "0017811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.