Individual provider Active NPI

Corynne L Sperry

  • Occupational Therapist
  • Puyallup, WA
National Provider Identifier
1720639073
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC60964599 Issued in WA
Practice address
10324 Canyon Rd E Ste 203
Puyallup, WA 98373-1013
Phone
(253) 471-2727
Fax
(253) 471-2730
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OC60964599 WA
Occupational Therapist 225X00000X OC60964599 WA Primary

Addresses

Primary practice location

10324 Canyon Rd E Ste 203
Puyallup, WA 98373-1013

Mailing address

10324 Canyon Rd E Ste 203
Puyallup, WA 98373-1013
Phone (253) 471-2727

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

LicenseStateTypeSpecialty
OC60964599WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Step Ahead in Pierce County Pediatrics PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1720639073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10324 CANYON RD E STE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731013",
            "telephone_number": "253-471-2727",
            "fax_number": "253-471-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10324 CANYON RD E STE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731013",
            "telephone_number": "253-471-2727",
            "fax_number": "253-471-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERRY",
        "first_name": "CORYNNE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OC60964599",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OC60964599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.