Active NPI
Tanner Reed
- Occupational Therapist
- Haxtun, CO
National Provider Identifier
1720567175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.0008453
- Practice address
- 235 W Fletcher St
Haxtun, CO 80731-2737 - Phone
- (970) 774-6123
- NPI assigned
- Aug 7, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 119278 | TX | |
| Occupational Therapist | 225X00000X | OT4426 | NM | |
| Occupational Therapist | 225X00000X | OT.0008453 | CO | Primary |
Addresses
Primary practice location
235 W Fletcher St
Haxtun, CO 80731-2737
Mailing address
235 W Fletcher St
Haxtun, CO 80731-2737
Phone (970) 774-6123
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 |
|---|---|---|---|
| OT.0008453 | CO | MD | Occupational Therapist |
| OT4426 | NM | MD | Occupational Therapist |
| 119278 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1720567175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 W FLETCHER ST",
"city": "HAXTUN",
"state": "CO",
"postal_code": "807312737",
"telephone_number": "970-774-6123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 W FLETCHER ST",
"city": "HAXTUN",
"state": "CO",
"postal_code": "807312737",
"telephone_number": "970-774-6123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REED",
"first_name": "TANNER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-07",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "119278",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "OT4426",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "OT.0008453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haxtun, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.