Active NPI
Codi S. Keenan, COTA
- Occupational Therapy Assistant
- N Royalton, OH
National Provider Identifier
1649774597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA007183
- Practice address
- 9001 W 130TH St
N Royalton, OH 44133-1011 - Phone
- (440) 237-3104
- NPI assigned
- Mar 23, 2018
- 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 Therapy Assistant | 224Z00000X | OTA007183 | OH | Primary |
Addresses
Primary practice location
9001 W 130TH St
N Royalton, OH 44133-1011
Mailing address
9001 W 130TH St
North Royalton, OH 44133-1011
Phone (440) 237-3104
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 |
|---|---|---|---|
| OTA007183 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521763200000",
"number": "1649774597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9001 W 130TH ST",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441331011",
"telephone_number": "440-237-3104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9001 W 130TH ST",
"city": "N ROYALTON",
"state": "OH",
"postal_code": "441331011",
"telephone_number": "440-237-3104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENAN",
"first_name": "CODI",
"middle_name": "S.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-23",
"last_updated": "2018-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA007183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in N Royalton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.