Karen M Cadle, COTA

Individual provider Active NPI Occupational Therapy Assistant · Portage, IN

NPI 1760680839 · NPPES record last updated Jul 10, 2007

Key facts

NPI
1760680839
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
32000093A (IN)
Practice address
6040 Lute Rd
Portage, IN 46368-5008
Phone
(219) 763-6858
Fax
(219) 763-4858
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
32000093AINMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32000093A IN Yes

Addresses

Primary practice location

6040 Lute Rd
Portage, IN 46368-5008

Mailing address

6040 Lute Rd
Portage, IN 46368-5008
Phone (219) 763-6858

Other identifiers

IdentifierTypeStateIssuer
32000093AOtherINSTATE LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 10, 2007.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1760680839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 LUTE RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685008",
            "telephone_number": "219-763-6858",
            "fax_number": "219-763-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 LUTE RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685008",
            "telephone_number": "219-763-6858",
            "fax_number": "219-763-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADLE",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32000093A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "32000093A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

All providers in Portage, IN · Occupational Therapy Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.