Nicole Mundstock, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6444 Issued in AZ

Practice address

500 N Bullard Ave
C27
Goodyear, AZ 85338-2533

Phone

(623) 986-5110

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1679930028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BULLARD AVE",
            "address_2": "C27",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382533",
            "telephone_number": "623-986-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BULLARD AVE",
            "address_2": "C27",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382533",
            "telephone_number": "623-986-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDSTOCK",
        "first_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "6444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Muhammad, RN
• Mahnoor Mukarram, DO
• Tyler Von Mullen, OD
• Multicentric Solution, LLC
• Melissa Priyanthie Munagamagedon
• Inez Munoz, LPN
• Cameron Murphy
• Desmond Murphy
• Tolana Murphy, LPCC
• David R Murray, PA

• Pediatric Occupational Therapist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.