Olivia Mary Clyde, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-1763 Issued in WY

Practice address

813 Cy Ave
Casper, WY 82601-4161

Phone

(307) 670-5303

NPI assigned

Feb 15, 2024

Last updated

Feb 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Live Inspired LLC

  • Developmentally Disabled Services Day Training Agency
  • Casper, WY
  • NPI 1629783683
  NPD

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1942065388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 CY AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014161",
            "telephone_number": "307-670-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 CY AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014161",
            "telephone_number": "307-670-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "OLIVIA",
        "middle_name": "MARY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WY",
            "license": "OTA-1763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John K Clements, O.D.
• John Ryan Clements, D.M.D.
• Austin Clemetson, DPT
• Jeffrey W Cloud, MD
• Angeline Clough
• Coats Companion Care Inc
• Garrett Coats
• Zachary David Cochran, PHARMD
• Coleman Cogswell, DPT
• Randi Michelle Cohen-Anderson, RN

• Occupational Therapy Assistant in Casper, WY
• Providers in Casper, WY by specialty
• Occupational Therapy Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.