Four Ravens Occupational Therapy LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

FOUR RAVENS OCCUPATIONAL THERAPY LLC

Practice address

69 Beach Road
Haines, AK 99827-0778

Phone

(907) 314-0808

Fax

(907) 766-2104

NPI assigned

May 17, 2021

Organization subpart

Yes

Parent organization

FOUR RAVENS OCCUPATIONAL THERAPY LLCAs reported in NPPES

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

Authorized official

Name

Margaret Michaelene Heyman-Hotch, MOT, OTR/LNPI 1972771798

Title

Owner, Lead Therapist

Phone

(907) 314-0808

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Four Ravens Occupational Therapy LLC

  • Occupational Therapist
  • Haines, AK
  • NPI 1821407867

  O20170209000053

  Same enrollment

Tax ID family

Four Ravens Occupational Therapy LLC2 organizations share this tax ID, including this one

Part of

Four Ravens Occupational Therapy LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Four Ravens Occupational Therapy LLC

  • Occupational Therapist
  • Haines, AK
  • NPI 1821407867
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Four Ravens Occupational Therapy LLC

  • Occupational Therapist
  • Haines, AK
  • NPI 1821407867
  NPPES parent name

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margaret Michaelene Heyman-Hotch, MOT, OTR/L

  • Occupational Therapist
  • Haines, AK
  • NPI 1972771798
  NPD Authorized official
• Brianna Gibbs Cooper, OTD, OTR/L

  • Occupational Therapist
  • Haines, AK
  • NPI 1316563760
  NPD
• Madeline Kathleen Haff, OT

  • Occupational Therapist
  • Haines, AK
  • NPI 1265949119
  NPD
• Erin McAvoy, COTA

  • Occupational Therapy Assistant
  • Juneau, AK
  • NPI 1417300906
  NPD
• Colleen Gay Zimick, COTA/L

  • Occupational Therapy Assistant
  • Klukwan, AK
  • NPI 1396454153
  NPD
• Tyler B Gilson, DPT

  • Physical Therapist
  • MC Alisterville, PA
  • NPI 1710290929

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1639743370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778",
            "city": "HAINES",
            "state": "AK",
            "postal_code": "998270778",
            "telephone_number": "907-314-0808",
            "fax_number": "907-766-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BEACH ROAD",
            "city": "HAINES",
            "state": "AK",
            "postal_code": "998270778",
            "telephone_number": "907-314-0808",
            "fax_number": "907-766-2104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9109 Mendenhall Mall Rd Ste 5K",
            "address_purpose": "LOCATION",
            "city": "Juneau",
            "state": "AK",
            "postal_code": "998017136",
            "country_code": "US",
            "telephone_number": "907-209-1288",
            "fax_number": "907-766-2104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9109 Mendenhall Mall Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Juneau",
            "state": "AK",
            "postal_code": "998017136",
            "country_code": "US",
            "telephone_number": "907-314-0808",
            "fax_number": "907-766-2104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUR RAVENS OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUR RAVENS OCCUPATIONAL THERAPY LLC",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "HEYMAN-HOTCH",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "MICHAELENE",
        "authorized_official_title_or_position": "OWNER, LEAD THERAPIST",
        "authorized_official_telephone_number": "907-314-0808",
        "authorized_official_credential": "MOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Dadourian, L.AC. DIPL. AC.
• Raven Davis
• Adam Kelley Dupaul, RN
• Leonard Feldman, MD
• Katherine Fossman, RDN, LD
• Four Ravens Occupational Therapy LLC
• Monique Octavia Frith
• Marie Rose Fudge
• Krystal R Gauley, LMT
• Claire Giordano

• Occupational Therapist in Haines, AK
• Providers in Haines, AK by specialty
• Occupational Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.