Active NPI
Nichelle Ryanne Carlberg, OTR/L
- Occupational Therapist
- Sinclairville, NY
National Provider Identifier
1891945259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 013110-1
- Practice address
- 5935 Route 60
Sinclairville, NY 14782-9666 - Phone
- (716) 962-5155
- Fax
- (716) 595-2481
- NPI assigned
- Sep 23, 2008
- 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 Therapist | 225X00000X | 013110-1 | NY | Primary |
Addresses
Primary practice location
5935 Route 60
Sinclairville, NY 14782-9666
Mailing address
5935 Route 60
PO Box 540
Sinclairville, NY 14782-9666
Phone (716) 962-5155
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 |
|---|---|---|---|
| 013110-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cassadaga Valley Central School District | Past | Accepting new patients |
Interoperability endpoints
- nichelle.r.carlberg@upmcdirect.com
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)
- Sinclairville, NY
- NPI 1578606182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1891945259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5935 ROUTE 60",
"address_2": "PO BOX 540",
"city": "SINCLAIRVILLE",
"state": "NY",
"postal_code": "147829666",
"telephone_number": "716-962-5155",
"fax_number": "716-595-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5935 ROUTE 60",
"city": "SINCLAIRVILLE",
"state": "NY",
"postal_code": "147829666",
"telephone_number": "716-962-5155",
"fax_number": "716-595-2481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLBERG",
"first_name": "NICHELLE",
"middle_name": "RYANNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "013110-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sinclairville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.