Individual provider Active NPI

Kassondra Dawn Thomason, COTA/L

  • Occupational Therapy Assistant
  • Casa Grande, AZ
National Provider Identifier
1568064152
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
046868 Issued in AZ
Practice address
442 W Kortsen Rd Ste 202
Casa Grande, AZ 85122-5923
Phone
(520) 208-5319
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 046868 AZ Primary

Addresses

Primary practice location

442 W Kortsen Rd Ste 202
Casa Grande, AZ 85122-5923

Mailing address

164 W Key West Dr
Casa Grande, AZ 85122-5257
Phone (520) 208-5319

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
046868AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1568064152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W KEY WEST DR",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225257",
            "telephone_number": "520-208-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 W KORTSEN RD STE 202",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225923",
            "telephone_number": "520-208-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "KASSONDRA",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "046868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.