Active NPI
Debra Green, COTA/L
- Occupational Therapy Assistant
- Canton, OH
National Provider Identifier
1881007219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 736
- Practice address
- 2100 38TH St NW
Canton, OH 44709-2312 - Phone
- (330) 492-8136
- NPI assigned
- Jun 3, 2014
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 736 | OH | Primary |
Addresses
Primary practice location
2100 38TH St NW
Canton, OH 44709-2312
Mailing address
2100 38TH St NW
Canton, OH 44709-2312
Phone (330) 492-8136
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 |
|---|---|---|---|
| 736 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stark County Edcuational Service Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Canton, OH
- NPI 1861681595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401753600000",
"number": "1881007219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 38TH ST NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447092312",
"telephone_number": "330-492-8136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 38TH ST NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447092312",
"telephone_number": "330-492-8136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DEBRA",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-03",
"last_updated": "2014-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.