Individual provider Active NPI

Robert Raymond Iacono, COTA/L

  • Occupational Therapy Assistant
  • West Warwick, RI
National Provider Identifier
1538412697
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
RIOTA00628 Issued in RI
Practice address
63 Bramble LN
West Warwick, RI 02893-5505
Phone
(401) 821-1395
NPI assigned
Oct 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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 RIOTA00628 RI Primary

Addresses

Primary practice location

63 Bramble LN
West Warwick, RI 02893-5505

Mailing address

63 Bramble LN
West Warwick, RI 02893-5505
Phone (401) 821-1395

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
RIOTA00628RIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1538412697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BRAMBLE LN",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935505",
            "telephone_number": "401-821-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BRAMBLE LN",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935505",
            "telephone_number": "401-821-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACONO",
        "first_name": "ROBERT",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "RI",
            "license": "RIOTA00628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.