Active NPI
Carly Victoria Meacham, MS, OTR/L
- Occupational Therapist
- Corning, NY
National Provider Identifier
1689904393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 015799-1
- Practice address
- 3942 Pine Hill Rd
Corning, NY 14830-9782 - Phone
- (607) 382-1426
- NPI assigned
- Dec 31, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 015799-1 | NY | Primary |
Addresses
Primary practice location
3942 Pine Hill Rd
Corning, NY 14830-9782
Mailing address
8020 Harrisburg Hollow Rd
Bath, NY 14810-8258
Phone (607) 382-1426
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015799-1 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1689904393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8020 HARRISBURG HOLLOW RD",
"city": "BATH",
"state": "NY",
"postal_code": "148108258",
"telephone_number": "607-382-1426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3942 PINE HILL RD",
"city": "CORNING",
"state": "NY",
"postal_code": "148309782",
"telephone_number": "607-382-1426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEACHAM",
"first_name": "CARLY",
"middle_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-31",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "015799-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corning, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.