Klarissa Autumn Hall, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2123 Issued in OK

Practice address

109 N Fairland St
Pryor, OK 74361-4203

Phone

(918) 825-1405

Fax

(918) 825-1406

NPI assigned

Mar 16, 2020

Last updated

Mar 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Klarissa Autumn Hall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1518593011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405",
            "fax_number": "918-825-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405",
            "fax_number": "918-825-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KLARISSA",
        "middle_name": "AUTUMN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KLARISSA",
            "last_name": "HALL",
            "middle_name": "AUTUMN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hac Inc (Homeland Pharmcy)
• Ashley Diane Hailey
• Charity Dalaina Hall, LPC
• Dennis James Hall
• Kimberly D Hall
• Christine Hamner, MS, LPC, LADC
• Cory Hancock
• Morgan Irene Hart
• Jason P Hartog, MPT
• Jamie Marie Hatstat

• Occupational Therapy Assistant in Pryor, OK
• Providers in Pryor, OK by specialty
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.