Individual provider Active NPI

Cedric Burton Sr., OTR/L

  • Occupational Therapist
  • Louisville, KY
National Provider Identifier
1669066007
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
170656 Issued in KY
Practice address
17018 Preserve Pointe Dr
Louisville, KY 40245-4740
Phone
(502) 390-1861
NPI assigned
Feb 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapist 225XE0001X 170656 KY
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X 170656 KY
Hand Occupational Therapist 225XH1200X 170656 KY
Occupational Therapist 225X00000X 170656 KY Primary

Addresses

Primary practice location

17018 Preserve Pointe Dr
Louisville, KY 40245-4740

Mailing address

17018 Preserve Pointe Dr
Louisville, KY 40245-4740
Phone (502) 390-1861

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

LicenseStateTypeSpecialty
170656KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1669066007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17018 PRESERVE POINTE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454740",
            "telephone_number": "502-390-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17018 PRESERVE POINTE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454740",
            "telephone_number": "502-390-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "CEDRIC",
        "name_suffix": "Sr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "KY",
            "license": "170656",
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "KY",
            "license": "170656",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "KY",
            "license": "170656",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "170656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.