Lydia Bradfortd Otiato, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31003922A Issued in IN

Practice address

1818 Georgian CT
South Bend, IN 46614-1878

Phone

(574) 514-8127

Fax

(574) 231-9021

NPI assigned

May 18, 2007

Last updated

Dec 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Therapy Innovations Inc.

  dba CTI Aging and Rehabilitative Services

  • Intellectual Disabilities Intermediate Care Facility
  • South Bend, IN
  • NPI 1407166192
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1821206608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 GEORGIAN CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141878",
            "telephone_number": "574-514-8127",
            "fax_number": "574-231-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 GEORGIAN CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141878",
            "telephone_number": "574-514-8127",
            "fax_number": "574-231-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORTD OTIATO",
        "first_name": "LYDIA",
        "name_prefix": "Mrs.",
        "credential": "MOT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003922A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Boyd, PHARMD
• Patrick William Boyle
• Brace Yourself Orthodontics LLC
• Dana G. Brackett, N.P.
• Jacob Alexander Braddock, D.O.
• Angelene Bradley, MA
• David Anthony Bradley, RBT
• Leena Bradley
• Shanti Bradley, M.ED., MBA, BCBA
• Jennae Bradshaw

• Occupational Therapist in South Bend, IN
• Providers in South Bend, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.