Active NPI
Tiffany L Bader, MS, OTR/L
- Occupational Therapist
- Riverton, WY
National Provider Identifier
1770722944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR-1151
- Practice address
- 1202 E Jackson Ave
Riverton, WY 82501-3866 - Phone
- (307) 856-4337
- NPI assigned
- Feb 11, 2009
- 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 Therapist | 225X00000X | OTR-1151 | WY | Primary |
Addresses
Primary practice location
1202 E Jackson Ave
Riverton, WY 82501-3866
Mailing address
1017 Rill CT
Riverton, WY 82501-3949
Phone (307) 797-3395
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR-1151 | WY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1770722944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 RILL CT",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825013949",
"telephone_number": "307-797-3395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 E JACKSON AVE",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825013866",
"telephone_number": "307-856-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADER",
"first_name": "TIFFANY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-11",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WY",
"license": "OTR-1151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.