Individual provider Active NPI

Randi Lee Teed

  • Occupational Therapist
  • Ithaca, NY
National Provider Identifier
1912788662
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025879-01 Issued in NY
Practice address
1 Bella Vista Dr
Ithaca, NY 14850-5792
Phone
(607) 375-6300
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC017838 PA
Occupational Therapist 225X00000X 025879-01 NY Primary

Addresses

Primary practice location

1 Bella Vista Dr
Ithaca, NY 14850-5792

Mailing address

6854 Irish Hill Rd
Friendsville, PA 18818-7751
Phone (570) 699-9611

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
025879-01NYMDOccupational Therapist
OC017838PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1912788662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6854 IRISH HILL RD",
            "city": "FRIENDSVILLE",
            "state": "PA",
            "postal_code": "188187751",
            "telephone_number": "570-699-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BELLA VISTA DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505792",
            "telephone_number": "607-375-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEED",
        "first_name": "RANDI",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017838",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025879-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.