Individual provider Active NPI

Andrea Nelson, OT

  • Occupational Therapist
  • Clive, IA
National Provider Identifier
1558726463
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
01270 Issued in IA
Practice address
12493 University Ave Ste 100
Clive, IA 50325-8286
Phone
(515) 358-9461
Fax
(515) 358-9489
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01270 IA Primary

Addresses

Primary practice location

12493 University Ave Ste 100
Clive, IA 50325-8286

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-9461

Other practice location 1

12493 University Ave Ste 100
Clive, IA 50325-8286
Phone (515) 358-0150

Other practice location 2

1111 6th Avenue
East Tower, Suite B3
Des Moines, IA 50314-2610
Phone (515) 358-0150

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

State licenses

LicenseStateTypeSpecialty
01270IAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1558726463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12493 UNIVERSITY AVE STE 100",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258286",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12493 University Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clive",
            "state": "IA",
            "postal_code": "503258286",
            "country_code": "US",
            "telephone_number": "515-358-0150",
            "fax_number": "515-358-0149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 6th Avenue",
            "address_2": "East Tower, Suite B3",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142610",
            "country_code": "US",
            "telephone_number": "515-358-0150",
            "fax_number": "515-358-0149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANDREA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.