Active NPI
Tialin Marie Hines, MS, OTR/L
- Occupational Therapist
- Canandaigua, NY
National Provider Identifier
1629314935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 63 017785
- Practice address
- 5415 North Bloomfield Road
Canandaigua, NY 14424 - Phone
- (585) 394-9510
- Fax
- (585) 394-5326
- NPI assigned
- Dec 14, 2012
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | 63 017785 | NY | Primary |
Addresses
Primary practice location
5415 North Bloomfield Road
Canandaigua, NY 14424
Mailing address
5415 Country Road 30
Canandaigua, NY 14424
Phone (585) 394-9510
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63 017785 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1629314935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 COUNTRY ROAD 30",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "14424",
"telephone_number": "585-394-9510",
"fax_number": "585-394-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5415 NORTH BLOOMFIELD ROAD",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "14424",
"telephone_number": "585-394-9510",
"fax_number": "585-394-5326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "TIALIN",
"middle_name": "MARIE",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-14",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "63 017785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.