NPIMap

Organization Active NPI

Ota the Koomar Center, LLC

  • Pediatric Occupational Therapist
  • Newton, MA
National Provider Identifier
1679167720
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
OTA THE KOOMAR CENTER, LLC
Practice address
74 Bridge St
Newton, MA 02458-1147
Phone
(617) 969-4410
NPI assigned
Mar 1, 2021
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Taylor Davidson
Title
Ceo
Phone
(617) 999-9585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

74 Bridge St
Newton, MA 02458-1147

Mailing address

15245 Shady Grove Rd Ste 110
Rockville, MD 20850-7202

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1679167720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD STE 110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BRIDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581147",
            "telephone_number": "617-969-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTA THE KOOMAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-999-9585"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.