Active NPI
Pamela R Arneson, COTA
- Occupational Therapy Assistant
- Rockford, IL
National Provider Identifier
1841571361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.001513
- Practice address
- 4401 N Main St
Rockford, IL 61103-1277 - Phone
- (779) 771-6866
- NPI assigned
- Aug 30, 2011
- 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 | 057.001513 | IL | Primary |
| Occupational Therapy Assistant | 224Z00000X | 397-27 | WI |
Addresses
Primary practice location
4401 N Main St
Rockford, IL 61103-1277
Mailing address
4401 N Main St
Rockford, IL 61103-1277
Phone (779) 771-6866
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 |
|---|---|---|---|
| 057.001513 | IL | MD | Occupational Therapy Assistant |
| 397-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1841571361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 N MAIN ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611031277",
"telephone_number": "779-771-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 N MAIN ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611031277",
"telephone_number": "779-771-6866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNESON",
"first_name": "PAMELA",
"middle_name": "R",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.001513",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "397-27",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.