NPIMap

Organization Active NPI

40:31 Rehab & Wellness, PLLC.

  • Occupational Therapist
  • Muskogee, OK
National Provider Identifier
1578081634
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2138 Issued in OK
Legal business name
40:31 REHAB & WELLNESS, PLLC.
Practice address
1805 N York St Ste H
Muskogee, OK 74403-1442
Phone
(918) 912-2796
Fax
(918) 513-5808
NPI assigned
Sep 8, 2017
Last updated
Sep 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Tara Michelle Ottenbacher, OTR/LNPI 1750729547
Title
Owner
Phone
(580) 982-8316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Occupational Therapist 225X00000X 2138 OK Primary
Speech-Language Assistant 2355S0801X NU
Speech-Language Pathologist 235Z00000X NU
Mental Health Occupational Therapist 225XM0800X NU

Addresses

Primary practice location

1805 N York St Ste H
Muskogee, OK 74403-1442

Mailing address

1805 N York St Ste H
Muskogee, OK 74403-1442
Phone (918) 912-2796

National Provider Directory

National Provider Directory

Locations

1805 N York St
Ste H
Muskogee, OK 74403
Phone (918) 686-7107

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1578081634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N YORK ST STE H",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031442",
            "telephone_number": "918-912-2796",
            "fax_number": "918-513-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N YORK ST STE H",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031442",
            "telephone_number": "918-912-2796",
            "fax_number": "918-513-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "40:31 REHAB & WELLNESS, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "OTTENBACHER",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-982-8316",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "2138",
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.