Active NPI
Angelica Butanda
- Occupational Therapy Assistant
- Oklahoma City, OK
National Provider Identifier
1730767658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2091
- Practice address
- 5300 N Meridian Ave Ste 9a
Oklahoma City, OK 73112-2137 - Phone
- (405) 410-8814
- Fax
- (405) 467-4552
- NPI assigned
- Mar 31, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2091 | OK | Primary |
Addresses
Primary practice location
5300 N Meridian Ave Ste 9a
Oklahoma City, OK 73112-2137
Mailing address
1420 N Regatta Dr
Oklahoma City, OK 73127-9709
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 |
|---|---|---|---|
| 2091 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1730767658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 N REGATTA DR",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731279709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 N MERIDIAN AVE STE 9A",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731122137",
"telephone_number": "405-410-8814",
"fax_number": "405-467-4552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTANDA",
"first_name": "ANGELICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2021-03-31",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "2091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.