NPIMap

Organization Active NPI

Full Spectrum Occupational Therapy

  • Occupational Therapist
  • Ithaca, NY
National Provider Identifier
1750959904
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
FULL SPECTRUM OCCUPATIONAL THERAPY
Practice address
15 Catherwood Rd
Ithaca, NY 14850-1071
Phone
(607) 227-4421
Fax
(607) 463-0602
NPI assigned
Jun 15, 2021
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Rebecca Fisher, MS, OTR/LNPI 1912230301
Title
Owner/Provider
Phone
(607) 227-4421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

15 Catherwood Rd
Ithaca, NY 14850-1071

Mailing address

96 Gunderman Rd
Ithaca, NY 14850-8624
Phone (607) 227-4421

Other identifiers 1

IdentifierTypeStateIssuer
06643489MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Fax Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211129000944 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4789074188 Receives reassigned benefits from 5 practitioners
Practice locations: Ithaca, NY

National Provider Directory

National Provider Directory

Locations

15 Catherwood Rd
Ithaca, NY 14850
Phone (607) 227-4421

2415 N Triphammer Rd
Ste 11
Ithaca, NY 14850
Phone (607) 227-4421

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1750959904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 GUNDERMAN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148508624",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CATHERWOOD RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501071",
            "telephone_number": "607-227-4421",
            "fax_number": "607-463-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM OCCUPATIONAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "607-227-4421",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06643489",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 Catherwood Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.