Individual provider Active NPI

Grace Westfall, COTA

  • Occupational Therapy Assistant
  • Vincennes, IN
National Provider Identifier
1588914386
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202007433 Issued in MI
Practice address
3801 Old Bruceville Rd
Vincennes, IN 47591-3889
Phone
(812) 886-4677
Fax
(812) 886-4678
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32002015A IN
Occupational Therapy Assistant 224Z00000X 5202007433 MI Primary

Addresses

Primary practice location

3801 Old Bruceville Rd
Vincennes, IN 47591-3889

Mailing address

26431 Yankee St
Edwardsburg, MI 49112-8630
Phone (269) 268-3609

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
32002015AINMDOccupational Therapy Assistant
5202007433MIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1588914386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26431 YANKEE ST",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128630",
            "telephone_number": "269-268-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 OLD BRUCEVILLE RD",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475913889",
            "telephone_number": "812-886-4677",
            "fax_number": "812-886-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTFALL",
        "first_name": "GRACE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002015A",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202007433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.