Individual provider Active NPI

Ashley Grauvogl, COTA

  • Occupational Therapy Assistant
  • Valparaiso, IN
National Provider Identifier
1942639679
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32002051A Issued in IN
Practice address
3405 Campbell St
Valparaiso, IN 46385-2363
Phone
(219) 462-1023
NPI assigned
Nov 4, 2013
Last updated
Nov 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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 32002051A IN Primary
Occupational Therapy Assistant 224Z00000X 057003456 IL

Addresses

Primary practice location

3405 Campbell St
Valparaiso, IN 46385-2363

Mailing address

1711 Cedar St
Valparaiso, IN 46383-4303
Phone (219) 689-1393

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
057003456ILMDOccupational Therapy Assistant
32002051AINMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1942639679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 CEDAR ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834303",
            "telephone_number": "219-689-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 CAMPBELL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463852363",
            "telephone_number": "219-462-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUVOGL",
        "first_name": "ASHLEY",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002051A",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057003456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.