Active NPI
Alma Balbon Utayde, OTR
- Occupational Therapist
- Mishawaka, IN
National Provider Identifier
1639236151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31002104A
- Practice address
- 54473 White Tail Dr
Mishawaka, IN 46545-1849 - Phone
- (574) 386-7555
- NPI assigned
- Jan 3, 2007
- 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 | 31002104A | IN | Primary |
Addresses
Primary practice location
54473 White Tail Dr
Mishawaka, IN 46545-1849
Mailing address
54473 White Tail Dr
Mishawaka, IN 46545-1849
Phone (574) 386-7555
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31002104A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meladjoy Therapy Services Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Mishawaka, IN
- NPI 1376600817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639236151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54473 WHITE TAIL DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451849",
"telephone_number": "574-386-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54473 WHITE TAIL DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451849",
"telephone_number": "574-386-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTAYDE",
"first_name": "ALMA",
"middle_name": "BALBON",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31002104A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
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.