Individual provider Active NPI

Amy Marie Nolan, OTR/L

  • Occupational Therapist
  • Parma, OH
National Provider Identifier
1669603429
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT005376 Issued in OH
Practice address
5520 Broadview Rd
Parma, OH 44134-1605
Phone
(216) 749-6650
Fax
(216) 749-1655
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005376 OH Primary

Addresses

Primary practice location

5520 Broadview Rd
Parma, OH 44134-1605

Mailing address

24806 Kennedy Ridge Rd
North Olmsted, OH 44070-3469
Phone (216) 225-0149

Other identifiers 3

IdentifierTypeStateIssuer
3158461MedicaidOH
000000603850OtherOHANTHEM BLUE CROSS AND BLUE SHEILD
12075740OtherOHCAQH

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

LicenseStateTypeSpecialty
OT005376OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1669603429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24806 KENNEDY RIDGE RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703469",
            "telephone_number": "216-225-0149",
            "fax_number": "216-901-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441341605",
            "telephone_number": "216-749-6650",
            "fax_number": "216-749-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT005376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3158461",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLUE SHEILD",
            "identifier": "000000603850",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12075740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.