Individual provider Active NPI

Jacqueline D Warmuth, OTR

  • Occupational Therapist
  • New Hartford, NY
National Provider Identifier
1891825618
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005185-1 Issued in NY
Practice address
2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613
Phone
(315) 797-3114
Fax
(315) 624-0474
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005185-1 NY Primary

Addresses

Primary practice location

2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613

Mailing address

9231 Shelley Dr
Marcy, NY 13403-2623
Phone (315) 797-3114

Other identifiers 2

IdentifierTypeStateIssuer
01815443MedicaidNY
00313539MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
005185-1NYMDMental Health Counselor
005185NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1891825618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9231 SHELLEY DR",
            "city": "MARCY",
            "state": "NY",
            "postal_code": "134032623",
            "telephone_number": "315-797-3114",
            "fax_number": "315-624-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 TILDEN AVE",
            "address_2": "BOX 1000",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133613",
            "telephone_number": "315-797-3114",
            "fax_number": "315-624-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARMUTH",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "005185-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01815443",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313539",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.