Individual provider Active NPI

Breck I Coulter, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Des Moines, IA
National Provider Identifier
1902788201
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
133879 Issued in IA
Practice address
1200 Pleasant St FL 1
Des Moines, IA 50309-1453
Phone
(515) 241-8550
NPI assigned
Jul 25, 2025
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 133879 IA Primary

Addresses

Primary practice location

1200 Pleasant St FL 1
Des Moines, IA 50309-1453

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1453
Phone (515) 241-8550

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
133879IAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1902788201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST FL 1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091453",
            "telephone_number": "515-241-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "BRECK",
        "middle_name": "I",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IA",
            "license": "133879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.