Active NPI
Tara R Whyte, OTR/L
- Occupational Therapist
- Charlestown, MA
National Provider Identifier
1861645012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10347
- Practice address
- 68 Russell St
Charlestown, MA 02129-2144 - Phone
- (617) 829-3003
- NPI assigned
- Nov 1, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 015229 | NY | |
| Pediatric Occupational Therapist | 225XP0200X | 015229-1 | NY | |
| Occupational Therapist | 225X00000X | 10347 | MA | Primary |
Addresses
Primary practice location
68 Russell St
Charlestown, MA 02129-2144
Mailing address
68 Russell St
Charlestown, MA 02129-2144
Phone (617) 829-3003
Other practice location 1
116 Central Park S Apt 17N
New York, NY 10019-1527
Phone (917) 402-0457
Other practice location 2
80 West End Avenue
New York, NY 10019
Phone (212) 683-6700
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10347 | MA | MD | Mental Health Counselor |
| 015229 | NY | MD | Speech-Language Pathologist |
| 015229-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1861645012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 RUSSELL ST",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021292144",
"telephone_number": "617-829-3003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 RUSSELL ST",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021292144",
"telephone_number": "617-829-3003"
}
],
"practiceLocations": [
{
"address_1": "116 Central Park S Apt 17N",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100191527",
"country_code": "US",
"telephone_number": "917-402-0457",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "80 West End Avenue",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10019",
"country_code": "US",
"telephone_number": "212-683-6700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHYTE",
"first_name": "TARA",
"middle_name": "R",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-01",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "015229",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "015229-1",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "10347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlestown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.