Active NPI
Marissa Jane Paulden
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1497931653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2230
- Practice address
- 13609 California St Ste 200
Omaha, NE 68154-5245 - Phone
- (402) 891-1118
- NPI assigned
- Jan 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 2230 | NM | Primary |
Addresses
Primary practice location
13609 California St Ste 200
Omaha, NE 68154-5245
Mailing address
4105 Hawksmoore Rd
Winston Salem, NC 27106-4281
Phone (336) 924-3380
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2230 | NM | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1497931653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 HAWKSMOORE RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271064281",
"telephone_number": "336-924-3380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13609 CALIFORNIA ST STE 200",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545245",
"telephone_number": "402-891-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULDEN",
"first_name": "MARISSA",
"middle_name": "JANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-17",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "2230",
"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 Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.