Individual provider Active NPI

Alyssa Ann Culicerto, OTR/L

  • Occupational Therapist
  • Charleston, WV
National Provider Identifier
1699359968
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1549 Issued in WV
Practice address
1778 Smith Rd
Charleston, WV 25314-2278
Phone
(130) 422-2332
NPI assigned
May 12, 2021
Last updated
May 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1549 WV Primary

Addresses

Primary practice location

1778 Smith Rd
Charleston, WV 25314-2278

Mailing address

1778 Smith Rd
Charleston, WV 25314-2278
Phone (130) 422-2332

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1549WVMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1699359968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 SMITH RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142278",
            "telephone_number": "130-422-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1778 SMITH RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142278",
            "telephone_number": "130-422-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULICERTO",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.