Active NPI
Rachel Marie Derus, COTA/L
- Occupational Therapy Assistant
- Washington, DC
National Provider Identifier
1700156668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0131000970
- Practice address
- 4829 41St St NW
Washington, DC 20016-1707 - Phone
- (216) 906-1025
- NPI assigned
- Jan 10, 2012
- Last updated
- Mar 5, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 0131000970 | VA | Primary |
| Occupational Therapy Assistant | 224Z00000X | 04381 | OH |
Addresses
Primary practice location
4829 41St St NW
Washington, DC 20016-1707
Mailing address
15636 Windmill Point Rd
Huntsburg, OH 44046-8766
Phone (216) 906-1025
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 |
|---|---|---|---|
| 0131000970 | VA | MD | Occupational Therapy Assistant |
| 04381 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330905600000",
"number": "1700156668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15636 WINDMILL POINT RD",
"city": "HUNTSBURG",
"state": "OH",
"postal_code": "440468766",
"telephone_number": "216-906-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4829 41ST ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200161707",
"telephone_number": "216-906-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUS",
"first_name": "RACHEL",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-10",
"last_updated": "2012-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "0131000970",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "04381",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.