Active NPI
Ken Maynell
- Occupational Therapy Assistant
- Aurora, CO
National Provider Identifier
1699213314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA.0000752
- Practice address
- 13123 E 16TH Ave
Aurora, CO 80045-7106 - Phone
- (720) 777-6645
- Fax
- (720) 777-6563
- NPI assigned
- Feb 1, 2017
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | OTA.0000752 | CO | Primary |
Addresses
Primary practice location
13123 E 16TH Ave
Aurora, CO 80045-7106
Mailing address
3615 Martin Luther King Blvd
Denver, CO 80205-4976
Phone (720) 777-6645
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA.0000752 | CO | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1699213314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 MARTIN LUTHER KING BLVD",
"city": "DENVER",
"state": "CO",
"postal_code": "802054976",
"telephone_number": "720-777-6645",
"fax_number": "720-777-6563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-6645",
"fax_number": "720-777-6563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNELL",
"first_name": "KEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-01",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CO",
"license": "OTA.0000752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.