Active NPI
Alivia Marie Fazio
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1508642455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 2701 Chestnut Station CT
Louisville, KY 40299-6395 - Phone
- (800) 335-1060
- NPI assigned
- Sep 6, 2023
- 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 | MA | Primary |
Addresses
Primary practice location
2701 Chestnut Station CT
Louisville, KY 40299-6395
Mailing address
160 W Broadway Unit 304
South Boston, MA 02127-1182
Phone (978) 835-8117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paragon Outpatient Rehabilitation Services, LLC | Current | Accepting new patients | |
| Paragon Outpatient Rehabilitation Services, LLC | Current | Accepting new patients |
Locations
303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572
2701 Chestnut Station Ct
Louisville, KY 40299
Phone (502) 964-5359
65 Briarwood Cir
Worcester, MA 01606
Phone (413) 304-2747
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Louisville, KY
- NPI 1871867325
MA
-
- Rehabilitation Clinic/Center
- Roxboro, NC
- NPI 1245014380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1508642455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 W BROADWAY UNIT 304",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021271182",
"telephone_number": "978-835-8117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 CHESTNUT STATION CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402996395",
"telephone_number": "800-335-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZIO",
"first_name": "ALIVIA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-06",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.