Occupational Therapy PA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT009 Issued in ID

Legal business name

OCCUPATIONAL THERAPY PA

Practice address

1820 E 17TH Street
Ste. 120
Idaho Falls, ID 83404-6472

Phone

(208) 529-3358

Fax

(208) 529-3382

NPI assigned

Jun 15, 2007

Organization subpart

No

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

Authorized official

Name

Janice Kytle Seargent, MED OTR/L-ATP

Title

Owner

Phone

(208) 529-3358

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1679778286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E 17TH STREET",
            "address_2": "STE. 120",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046472",
            "telephone_number": "208-529-3358",
            "fax_number": "208-529-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E 17TH STREET",
            "address_2": "STE. 120",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046472",
            "telephone_number": "208-529-3358",
            "fax_number": "208-529-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL THERAPY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "SEARGENT",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "KYTLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-3358",
        "authorized_official_credential": "MED OTR/L-ATP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.