Individual provider Active NPI

Ruth Ellen Wallick, COTAL

  • Occupational Therapy Assistant
  • York, PA
National Provider Identifier
1598896425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OP003432L Issued in PA
Practice address
970 Colonial Ave
York, PA 17403-3430
Phone
(717) 845-2661
Fax
(717) 845-3101
NPI assigned
Mar 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OP003432L PA Primary

Addresses

Primary practice location

970 Colonial Ave
York, PA 17403-3430

Mailing address

24 Red Barberry Dr
Etters, PA 17319-9355
Phone (717) 718-5478

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
OP003432LPAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598896425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RED BARBERRY DR",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199355",
            "telephone_number": "717-718-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 COLONIAL AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033430",
            "telephone_number": "717-845-2661",
            "fax_number": "717-845-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLICK",
        "first_name": "RUTH ELLEN",
        "name_prefix": "Mrs.",
        "credential": "COTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP003432L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

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.

Verify at the official NPI Registry.