Individual provider Active NPI

Pamela Phipps

  • Occupational Therapy Assistant
  • Clintwood, VA
National Provider Identifier
1912399015
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
BOTOTA00216191 Issued in KY
Practice address
1532 Wolfe Pen Rd
Clintwood, VA 24228-6930
Phone
(276) 926-8081
NPI assigned
Feb 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X BOTOTA00216191 KY Primary
Occupational Therapy Assistant 224Z00000X 0131001396 VA

Addresses

Primary practice location

1532 Wolfe Pen Rd
Clintwood, VA 24228-6930

Mailing address

1532 Wolfe Pen Rd
Clintwood, VA 24228-6930
Phone (276) 926-8081

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
BOTOTA00216191KYMDOccupational Therapy Assistant
0131001396VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1912399015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 WOLFE PEN RD",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242286930",
            "telephone_number": "276-926-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 WOLFE PEN RD",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242286930",
            "telephone_number": "276-926-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "BOTOTA00216191",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131001396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clintwood, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.