Amy C Collins Tucker, OTRL – Occupational Therapist

Key facts

NPI: 1568500072
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: R1561 (KY)
Practice address: 11549 Sutherland Dr
Walton, KY 41094-7412
Phone: (859) 485-1121
Fax: (859) 485-1121
NPI assigned: Feb 5, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Pediatric Therapy Specialists, Inc. Specialist · Florence, KY · NPI 1255537171

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
R1561	KY	MD	Occupational Therapist

Practice roles

Organization	Specialty	Status	New patients
Pediatric Therapy Specialists, Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	R1561	KY	Yes

Addresses

Primary practice location

11549 Sutherland Dr
Walton, KY 41094-7412

Mailing address

11549 Sutherland Dr
Walton, KY 41094
Phone (859) 485-1121

Other names

Amy Christine Collins Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568500072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11549 SUTHERLAND DR",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "41094",
            "telephone_number": "859-485-1121",
            "fax_number": "859-485-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11549 SUTHERLAND DR",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "410947412",
            "telephone_number": "859-485-1121",
            "fax_number": "859-485-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "AMY",
        "middle_name": "C COLLINS",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R1561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "COLLINS",
            "middle_name": "CHRISTINE",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walton, KY

All providers in Walton, KY · Occupational Therapist in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.