Individual provider Active NPI

Susan M Bowerman, COTA

  • Occupational Therapy Assistant
  • Amarillo, TX
National Provider Identifier
1508094459
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
210271 Issued in TX
Practice address
1250 Wallace Blvd
Amarillo, TX 79106-1741
Phone
(806) 353-3596
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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 210271 TX Primary

Addresses

Primary practice location

1250 Wallace Blvd
Amarillo, TX 79106-1741

Mailing address

1250 Wallace Blvd
Amarillo, TX 79106-1741
Phone (806) 353-3596

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1508094459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061741",
            "telephone_number": "806-353-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061741",
            "telephone_number": "806-353-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERMAN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "210271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.