Individual provider Active NPI

Julie Christen Sopha, OTR/L

  • Occupational Therapist
  • Waverly, IA
National Provider Identifier
1578828059
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
002045 Issued in IA
Practice address
1810 4TH St SW Ste 103a
Waverly, IA 50677-4389
Phone
(319) 352-1234
Fax
(319) 352-4655
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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 002045 IA Primary

Addresses

Primary practice location

1810 4TH St SW Ste 103a
Waverly, IA 50677-4389

Mailing address

1810 4TH St SW Ste 103a
Waverly, IA 50677-4389
Phone (319) 352-1234

Other identifiers 1

IdentifierTypeStateIssuer
0665992MedicaidIA

Other names 1

  • Julie Christen Johnson Former name

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
002045IAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1578828059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 4TH ST SW STE 103A",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506774389",
            "telephone_number": "319-352-1234",
            "fax_number": "319-352-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 4TH ST SW STE 103A",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506774389",
            "telephone_number": "319-352-1234",
            "fax_number": "319-352-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPHA",
        "first_name": "JULIE",
        "middle_name": "CHRISTEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "002045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665992",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "JOHNSON",
            "middle_name": "CHRISTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.