Individual provider Active NPI

Autumn Bailey, MOTR/L

  • Occupational Therapist
  • Altoona, PA
National Provider Identifier
1851689632
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC008656 Issued in PA
Practice address
501 Valley View Blvd
Altoona, PA 16602-6410
Phone
(814) 205-1404
Fax
(814) 201-2021
NPI assigned
Jul 14, 2011
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 OC008656 PA Primary

Addresses

Primary practice location

501 Valley View Blvd
Altoona, PA 16602-6410

Mailing address

501 Valley View Blvd
Altoona, PA 16602-6410
Phone (814) 205-1404

Other practice location 1

821 Walnut St
Roaring Spring, PA 16673-1529
Phone (814) 224-0058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200219002198 PA Practitioner - Occupational Therapist in Private Practice 3870920549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare PT LPGroup PAC ID 3476790767, 17 clinicians

Practice addresses (Care Compare)

3200 Fairway Dr
Altoona, PA 16602-4458
Phone (814) 941-7708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC008656PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Care Health Systems Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1851689632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026410",
            "telephone_number": "814-205-1404",
            "fax_number": "814-201-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026410",
            "telephone_number": "814-205-1404",
            "fax_number": "814-201-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Roaring Spring",
            "state": "PA",
            "postal_code": "166731529",
            "country_code": "US",
            "telephone_number": "814-224-0058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "AUTUMN",
        "name_prefix": "Ms.",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC008656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.