Individual provider Active NPI

Krystle Augusta, COTA

  • Occupational Therapy Assistant
  • Goshen, NY
National Provider Identifier
1881997237
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
006888-1 Issued in NY
Practice address
2 Fletcher St
Goshen, NY 10924-1402
Phone
(845) 294-8806
Fax
(845) 294-8650
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 006888-1 NY Primary

Addresses

Primary practice location

2 Fletcher St
Goshen, NY 10924-1402

Mailing address

2 Fletcher St
Goshen, NY 10924-1402
Phone (845) 294-8806

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

LicenseStateTypeSpecialty
006888-1NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1881997237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FLETCHER ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241402",
            "telephone_number": "845-294-8806",
            "fax_number": "845-294-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FLETCHER ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241402",
            "telephone_number": "845-294-8806",
            "fax_number": "845-294-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTA",
        "first_name": "KRYSTLE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "006888-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.