Individual provider Active NPI

Tina Morrow, OT

  • Occupational Therapist
  • Bedford, IN
National Provider Identifier
1811160294
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31000825A Issued in IN
Practice address
2137 16TH St
Bedford, IN 47421-3003
Phone
(812) 275-5593
Fax
(812) 275-5624
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2022

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 31000825A IN Primary

Addresses

Primary practice location

2137 16TH St
Bedford, IN 47421-3003

Mailing address

2137 16TH St
Bedford, IN 47421-3003
Phone (812) 275-5593

Other names 1

  • Tina Waggoner Former name

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

LicenseStateTypeSpecialty
31000825AINMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1811160294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 16TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213003",
            "telephone_number": "812-275-5593",
            "fax_number": "812-275-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 16TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213003",
            "telephone_number": "812-275-5593",
            "fax_number": "812-275-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORROW",
        "first_name": "TINA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000825A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "WAGGONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.