Individual provider Active NPI

Taylor Silva, OTR/L

  • Occupational Therapist
  • Meridian, ID
National Provider Identifier
1700437944
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2123 Issued in ID
Practice address
3368 E Goldstone Dr
Meridian, ID 83642-1026
Phone
(208) 899-7992
NPI assigned
Sep 27, 2019
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 OT-2123 ID Primary

Addresses

Primary practice location

3368 E Goldstone Dr
Meridian, ID 83642-1026

Mailing address

3368 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 899-7992

Other names 1

  • Taylor Staudenmaier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191101001137 ID Practitioner - Occupational Therapist in Private Practice 2466784913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-2123IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adapt Therapy LLC CurrentSince Jul 21, 2024 Accepting new patients
Primary Therapy Source LLC Occupational Therapist CurrentSince Sep 30, 2019 Accepting new patients
Primary Therapy Source, LLC Occupational Therapist CurrentSince Sep 30, 2019 Accepting new patients

Locations

1259 Overland Ave
Burley, ID 83318
Phone (208) 647-0184

3368 E Goldstone Dr
Meridian, ID 83642
Phone (208) 899-7992

254 River Vista Pl
Twin Falls, ID 83301
Phone (208) 734-7333

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1700437944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3368 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-899-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3368 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-899-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "TAYLOR",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "STAUDENMAIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.