Active NPI
Susan Livingston, OTR
- Pediatric Occupational Therapist
- Bayfield, CO
National Provider Identifier
1871653089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- NBCOT#208009
- Practice address
- 110 East South Street
Bayfield, CO 81122 - Phone
- (970) 884-3259
- Fax
- (970) 884-2842
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | NBCOT#208009 | CO | Primary |
Addresses
Primary practice location
110 East South Street
Bayfield, CO 81122
Mailing address
PO Box 966
Bayfield, CO 81122-0966
Phone (970) 884-3259
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87481031 | Medicaid | CO | |
| 611557 | Other | CO | ANTHEM BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NBCOT#208009 | CO | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871653089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 966",
"city": "BAYFIELD",
"state": "CO",
"postal_code": "811220966",
"telephone_number": "970-884-3259",
"fax_number": "970-884-2842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 EAST SOUTH STREET",
"city": "BAYFIELD",
"state": "CO",
"postal_code": "81122",
"telephone_number": "970-884-3259",
"fax_number": "970-884-2842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVINGSTON",
"first_name": "SUSAN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CO",
"license": "NBCOT#208009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "87481031",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "611557",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.