NPIMap

Organization Active NPI

Pediatric Potentials

  • Pediatric Occupational Therapist
  • Bozeman, MT
National Provider Identifier
1861912792
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
863 Issued in MT
Legal business name
PEDIATRIC POTENTIALS
Practice address
1122 E Main St Ste 4
Bozeman, MT 59715-3888
Phone
(406) 582-4182
Fax
(406) 582-4148
NPI assigned
Jun 21, 2017
Last updated
Jun 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Mrs. Rebecca Louise Taylor, OCCUPATIONAL THERAPYNPI 1124159264
Title
Occupational Therapist
Phone
(406) 582-4182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X 863 MT Primary

Addresses

Primary practice location

1122 E Main St Ste 4
Bozeman, MT 59715-3888

Mailing address

519 E Fridley St
Bozeman, MT 59715-3717
Phone (406) 582-4182

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1861912792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 E FRIDLEY ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153717",
            "telephone_number": "406-582-4182",
            "fax_number": "406-582-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E MAIN ST STE 4",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153888",
            "telephone_number": "406-582-4182",
            "fax_number": "406-582-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC POTENTIALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "406-582-4182",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OCCUPATIONAL THERAPY"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.