Active NPI
Alicia Anne Gavula, COTA
- Occupational Therapy Assistant
- Bedford, NH
National Provider Identifier
1659780963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 684
- Practice address
- 30 Colby CT
Bedford, NH 03110-6426 - Phone
- (603) 625-6462
- NPI assigned
- Aug 12, 2014
- Last updated
- Aug 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 684 | NH | Primary |
Addresses
Primary practice location
30 Colby CT
Bedford, NH 03110-6426
Mailing address
PO Box 85465
Lexington, SC 20973
Phone (401) 258-0485
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 |
|---|---|---|---|
| 684 | NH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407801600000",
"number": "1659780963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 85465",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "20973",
"telephone_number": "401-258-0485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 COLBY CT",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106426",
"telephone_number": "603-625-6462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVULA",
"first_name": "ALICIA",
"middle_name": "ANNE",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-12",
"last_updated": "2014-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NH",
"license": "684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.