Individual provider Active NPI

Chad R Fletcher, O.T.R.L

  • Occupational Therapist
  • Cedar City, UT
National Provider Identifier
1780606848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
285163-4201 Issued in UT
Practice address
166 W 1325 N
Ste 100
Cedar City, UT 84720-7792
Phone
(435) 586-0064
Fax
(435) 867-1243
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 285163-4201 UT Primary

Addresses

Primary practice location

166 W 1325 N
Ste 100
Cedar City, UT 84720-7792

Mailing address

166 W 1325 N
Ste 100
Cedar City, UT 84720-7792
Phone (435) 586-0064

Other identifiers 2

IdentifierTypeStateIssuer
107021541101OtherUTSELECT HEALTH
75029OtherUTPEHP

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

State licenses

LicenseStateTypeSpecialty
285163-4201UTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780606848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 W 1325 N",
            "address_2": "STE 100",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847207792",
            "telephone_number": "435-586-0064",
            "fax_number": "435-867-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 W 1325 N",
            "address_2": "STE 100",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847207792",
            "telephone_number": "435-586-0064",
            "fax_number": "435-867-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "CHAD",
        "middle_name": "R",
        "credential": "O.T.R.L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "285163-4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "107021541101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "75029",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.