Individual provider Active NPI

Katrina Panozzo, COTA/L

  • Occupational Therapy Assistant
  • Albuquerque, NM
National Provider Identifier
1548824311
Registry record updated Apr 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-3220 Issued in NM
Practice address
8820 Horizon Blvd NE
Albuquerque, NM 87113-1689
Phone
(505) 550-1440
NPI assigned
Apr 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2019

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 OTA-3220 NM Primary

Addresses

Primary practice location

8820 Horizon Blvd NE
Albuquerque, NM 87113-1689

Mailing address

1740 Geraldine PL SE
Rio Rancho, NM 87124-2746
Phone (505) 550-1440

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
OTA-3220NMMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1556323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556323200000",
    "number": "1548824311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 GERALDINE PL SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242746",
            "telephone_number": "505-550-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 HORIZON BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131689",
            "telephone_number": "505-550-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOZZO",
        "first_name": "KATRINA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-27",
        "last_updated": "2019-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "OTA-3220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2019; 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.