Individual provider Active NPI

Amy Lupardus, M.S., OTR/L

  • Occupational Therapist
  • Bowling Green, KY
National Provider Identifier
1770528978
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
R5183 Issued in KY
Practice address
84 Trapper Way
Bowling Green, KY 42103-7035
Phone
(229) 854-7216
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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 4320 GA
Occupational Therapist 225X00000X R5183 KY Primary

Addresses

Primary practice location

84 Trapper Way
Bowling Green, KY 42103-7035

Mailing address

84 Trapper Way
Bowling Green, KY 42103-7035
Phone (229) 854-7216

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4320GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Associates, LLC Pediatrics CurrentSince Apr 9, 2024 Accepting new patients
Gateway Counseling Services Past Accepting new patients

Organizations & group practices 2

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1770528978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 TRAPPER WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037035",
            "telephone_number": "229-854-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 TRAPPER WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037035",
            "telephone_number": "229-854-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPARDUS",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "4320",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R5183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.