Active NPI
Kathy Marie Hall, COTA,PTA
- Specialist
- Divide, CO
National Provider Identifier
1801091632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A-0570
- Practice address
- 4060 Omer Rd
Divide, CO 80814-8801 - Phone
- (719) 250-0543
- NPI assigned
- Jun 20, 2007
- Last updated
- Apr 23, 2011
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | A-0570 | NM | Primary |
Addresses
Primary practice location
4060 Omer Rd
Divide, CO 80814-8801
Mailing address
4060 Omer Rd
Divide, CO 80814-8801
Phone (719) 250-0543
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
| License | State | Type | Specialty |
|---|---|---|---|
| A-0570 | NM | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303516800000",
"number": "1801091632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 OMER RD",
"city": "DIVIDE",
"state": "CO",
"postal_code": "808148801",
"telephone_number": "719-250-0543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 OMER RD",
"city": "DIVIDE",
"state": "CO",
"postal_code": "808148801",
"telephone_number": "719-250-0543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "KATHY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "COTA,PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2011-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "A-0570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Divide, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.