Dominique Oldham, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

085075 Issued in IA

Practice address

8950 Coachlight Dr
West Des Moines, IA 50266-8778

Phone

(515) 375-2100

NPI assigned

Nov 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dominique Oldham Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1821756636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14605 E 257TH AVE",
            "city": "EAGLEVILLE",
            "state": "MO",
            "postal_code": "644429137",
            "telephone_number": "515-771-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 COACHLIGHT DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668778",
            "telephone_number": "515-375-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "DOMINIQUE",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IA",
            "license": "085075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Documentation",
            "affiliation": "N",
            "endpointDescription": "Phone",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "None",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "8950 Coachlight Dr",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502668778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cedar",
            "affiliation": "N",
            "endpointDescription": "None",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "8950 Coachlight Dr",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502668778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "OLDHAM",
            "credential": "OTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Occupational Therapy Assistant in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Occupational Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.