Active NPI
Marie Dominique Neal, OTR/L
- Occupational Therapist
- Dyer, IN
National Provider Identifier
1780862276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.007975
- Practice address
- 13822 Empress LN
Dyer, IN 46311-7070 - Phone
- (312) 203-1706
- NPI assigned
- Feb 6, 2008
- Last updated
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 056.007975 | IL | Primary |
Addresses
Primary practice location
13822 Empress LN
Dyer, IN 46311-7070
Mailing address
13822 Empress LN
Dyer, IN 46311-7070
Phone (312) 203-1706
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.007975 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1780862276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13822 EMPRESS LN",
"city": "DYER",
"state": "IN",
"postal_code": "463117070",
"telephone_number": "312-203-1706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13822 EMPRESS LN",
"city": "DYER",
"state": "IN",
"postal_code": "463117070",
"telephone_number": "312-203-1706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAL",
"first_name": "MARIE",
"middle_name": "DOMINIQUE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-06",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.007975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.