Michelle C Dicus, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA.0001796 Issued in CO

Practice address

901 N Sante Fe Ave
Fountain, CO 80817

Phone

(719) 822-0550

NPI assigned

Nov 13, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1871317198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 ACADEMY PL STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N SANTE FE AVE",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "80817",
            "telephone_number": "719-822-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICUS",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "OTA.0001796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jovita Deegan, DPT
• Darren Kyle Dennis, PA
• Dentists of Fountain, LLP
• Angela Derosier, PTA
• Jeffrey David Derry, LPC
• Dillon Companies LLC
• Jiangguang Ding
• Arely Dominguez Gonzalez, FNP
• Courtney Kathryn Domme, DENTIST
• Marcela Teresa Donat, PT, DPT

• Occupational Therapy Assistant in Fountain, CO
• Providers in Fountain, CO by specialty
• Occupational Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.