Individual provider Active NPI

Diane Lyn Mayhew, OTR/L

  • Occupational Therapist
  • Council Bluffs, IA
National Provider Identifier
1841592995
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
01033 Issued in IA
Practice address
1600 McPherson Ave
Council Bluffs, IA 51503-4858
Phone
(712) 322-9285
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01033 IA Primary

Addresses

Primary practice location

1600 McPherson Ave
Council Bluffs, IA 51503-4858

Mailing address

60908 Levi Rd
Glenwood, IA 51534-6426
Phone (712) 527-3064

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

LicenseStateTypeSpecialty
01033IAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1841592995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60908 LEVI RD",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515346426",
            "telephone_number": "712-527-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MCPHERSON AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034858",
            "telephone_number": "712-322-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHEW",
        "first_name": "DIANE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.