Active NPI
Robert Arthur Sidway, OTR/L
- Occupational Therapist
- Truth Or Consequences, NM
National Provider Identifier
1700077948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2006
- Practice address
- 992 S Broadway St
Truth Or Consequences, NM 87901-3198 - Phone
- (505) 894-4269
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 2006 | NM | Primary |
Addresses
Primary practice location
992 S Broadway St
Truth Or Consequences, NM 87901-3198
Mailing address
702 E 7TH Ave
Truth Or Consequences, NM 87901-1902
Phone (505) 894-6923
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 |
|---|---|---|---|
| 2006 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186272000000",
"number": "1700077948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 E 7TH AVE",
"city": "TRUTH OR CONSEQUENCES",
"state": "NM",
"postal_code": "879011902",
"telephone_number": "505-894-6923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "992 S BROADWAY ST",
"city": "TRUTH OR CONSEQUENCES",
"state": "NM",
"postal_code": "879013198",
"telephone_number": "505-894-4269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDWAY",
"first_name": "ROBERT",
"middle_name": "ARTHUR",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2007-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "2006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truth Or Consequences, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.