Active NPI
Melissa Lynn Sutton, COTA/L
- Occupational Therapy Assistant
- Gold Beach, OR
National Provider Identifier
1831527142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1053450
- Practice address
- 94220 4TH St
Gold Beach, OR 97444-7756 - Phone
- (541) 247-3000
- NPI assigned
- Oct 23, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1053450 | OR | Primary |
| Occupational Therapy Assistant | 224Z00000X | 057.002249 | IL |
Addresses
Primary practice location
94220 4TH St
Gold Beach, OR 97444-7756
Mailing address
94454 11TH Street
Gold Beach, OR 97444
Phone (217) 552-5870
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 |
|---|---|---|---|
| 057.002249 | IL | MD | Occupational Therapy Assistant |
| 1053450 | OR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382486400000",
"number": "1831527142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94454 11TH STREET",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "97444",
"telephone_number": "217-552-5870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94220 4TH ST",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974447756",
"telephone_number": "541-247-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "MELISSA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-23",
"last_updated": "2013-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OR",
"license": "1053450",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.002249",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gold Beach, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.