Individual provider Active NPI

Nicole Owen, OTR

  • Occupational Therapist
  • Springfield, MA
National Provider Identifier
1619611316
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13364 Issued in MA
Practice address
332 Birnie Ave
Springfield, MA 01107-1104
Phone
(413) 733-6624
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13364 MA Primary

Addresses

Primary practice location

332 Birnie Ave
Springfield, MA 01107-1104

Mailing address

670 Allen St
Springfield, MA 01118-2008

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
13364MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1619611316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011182008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 BIRNIE AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071104",
            "telephone_number": "413-733-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "NICOLE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.