Active NPI
Rebecca Ann Requarth, MSOT
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1811236631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31005435A
- Practice address
- 6635 East 21St Street
Suite 100, West Building
Indianapolis, IN 46219-2254 - Phone
- (317) 608-2824
- Fax
- (765) 454-9759
- NPI assigned
- Feb 14, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 31005435A | IN | |
| Occupational Therapist | 225X00000X | 31005435A | IN | Primary |
Addresses
Primary practice location
6635 East 21St Street
Suite 100, West Building
Indianapolis, IN 46219-2254
Mailing address
3500 Depauw Boulevard
Suite 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
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 |
|---|---|---|---|
| 31005435A | IN | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1811236631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 DEPAUW BOULEVARD",
"address_2": "SUITE 3070",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462686135",
"telephone_number": "855-324-0885",
"fax_number": "765-454-9759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6635 EAST 21ST STREET",
"address_2": "SUITE 100, WEST BUILDING",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462192254",
"telephone_number": "317-608-2824",
"fax_number": "765-454-9759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REQUARTH",
"first_name": "REBECCA",
"middle_name": "ANN",
"credential": "MSOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-14",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IN",
"license": "31005435A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005435A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.