Active NPI
Tiffany Nicole Engstrom, OT
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1750540878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3584
- Practice address
- 3901 Dutchmans LN
Suite 104
Louisville, KY 40207-4722 - Phone
- (502) 899-9927
- Fax
- (502) 899-5810
- NPI assigned
- Jun 4, 2008
- 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 Therapist | 225X00000X | 3584 | TN | Primary |
| Occupational Therapist | 225X00000X | R4158 | KY |
Addresses
Primary practice location
3901 Dutchmans LN
Suite 104
Louisville, KY 40207-4722
Mailing address
3901 Dutchmans LN
Suite 104
Louisville, KY 40207-4722
Phone (502) 899-9927
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3584 | TN | MD | Chiropractor |
| R4158 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240790400000",
"number": "1750540878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 DUTCHMANS LN",
"address_2": "SUITE 104",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074722",
"telephone_number": "502-899-9927",
"fax_number": "502-899-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 DUTCHMANS LN",
"address_2": "SUITE 104",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074722",
"telephone_number": "502-899-9927",
"fax_number": "502-899-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGSTROM",
"first_name": "TIFFANY",
"middle_name": "NICOLE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-04",
"last_updated": "2009-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "3584",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "R4158",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.