Individual provider Active NPI

Samantha Donaldson

  • Occupational Therapy Assistant
  • Phoenix, AZ
National Provider Identifier
1790501260
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-046661 Issued in AZ
Practice address
7080 N 19TH Ave
Phoenix, AZ 85021-8585
Phone
(480) 530-0890
NPI assigned
Nov 29, 2024
Last updated
Nov 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-046661 AZ Primary

Addresses

Primary practice location

7080 N 19TH Ave
Phoenix, AZ 85021-8585

Mailing address

53 W Oregon Ave
Phoenix, AZ 85013-2022
Phone (602) 575-1930

Other practice location 1

53 W Oregon Ave
Phoenix, AZ 85013-2022
Phone (602) 575-1930

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
OTA-046661AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1790501260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W OREGON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132022",
            "telephone_number": "602-575-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218585",
            "telephone_number": "480-530-0890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 W Oregon Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850132022",
            "country_code": "US",
            "telephone_number": "602-575-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-046661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.