Active NPI
Madonna McGregor Vincent, COTA/L
- Occupational Therapy Assistant
- North Ridgeville, OH
National Provider Identifier
1619393451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA.05410
- Practice address
- 34600 Bainbridge Rd
North Ridgeville, OH 44039-4073 - Phone
- (440) 327-1992
- NPI assigned
- Mar 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | OTA.05410 | OH | Primary |
Addresses
Primary practice location
34600 Bainbridge Rd
North Ridgeville, OH 44039-4073
Mailing address
29621 Foote Rd
Bay Village, OH 44140-1216
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 |
|---|---|---|---|
| OTA.05410 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1619393451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29621 FOOTE RD",
"city": "BAY VILLAGE",
"state": "OH",
"postal_code": "441401216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34600 BAINBRIDGE RD",
"city": "NORTH RIDGEVILLE",
"state": "OH",
"postal_code": "440394073",
"telephone_number": "440-327-1992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGREGOR VINCENT",
"first_name": "MADONNA",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA.05410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Ridgeville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.