Individual provider Active NPI

Kristin Mendozza, OTR/L

  • Occupational Therapist
  • Aurora, CO
National Provider Identifier
1609297092
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-720 Issued in CO
Practice address
8152 S Langdale Way
Aurora, CO 80016-7368
Phone
(720) 878-1165
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X 720 CO
Occupational Therapist 225X00000X OT-720 CO Primary

Addresses

Primary practice location

8152 S Langdale Way
Aurora, CO 80016-7368

Mailing address

8152 S Langdale Way
Aurora, CO 80016-7368
Phone (720) 878-1165

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
OT-720COMDOccupational Therapist
720COMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1609297092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8152 S LANGDALE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800167368",
            "telephone_number": "720-878-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8152 S LANGDALE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800167368",
            "telephone_number": "720-878-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZZA",
        "first_name": "KRISTIN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "720",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT-720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.