Active NPI
Trinity Reynolds, C.O.T.A.
- Occupational Therapy Assistant
- Chesterton, IN
National Provider Identifier
1588788665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 99025375
- Practice address
- 1120 S Calumet Rd
Suite 3
Chesterton, IN 46304-3285 - Phone
- (219) 983-9675
- Fax
- (219) 983-9681
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 99025375 | IN | Primary |
Addresses
Primary practice location
1120 S Calumet Rd
Suite 3
Chesterton, IN 46304-3285
Mailing address
1120 S Calumet Rd
Suite 3
Chesterton, IN 46304-3285
Phone (219) 983-9675
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
| License | State | Type | Specialty |
|---|---|---|---|
| 99025375 | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588788665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S CALUMET RD",
"address_2": "SUITE 3",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463043285",
"telephone_number": "219-983-9675",
"fax_number": "219-983-9681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S CALUMET RD",
"address_2": "SUITE 3",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463043285",
"telephone_number": "219-983-9675",
"fax_number": "219-983-9681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "TRINITY",
"credential": "C.O.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "99025375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.