NPIMap

Individual provider Active NPI

Latisha Rudolph

  • Occupational Therapy Assistant
  • Chester, PA
National Provider Identifier
1952700262
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OP007894 Issued in PA
Practice address
1315 Renshaw Rd Apt B2
Chester, PA 19013-1569
Phone
(717) 208-3799
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OP007894 PA Primary

Addresses

Primary practice location

1315 Renshaw Rd Apt B2
Chester, PA 19013-1569

Mailing address

1315 Renshaw Rd Apt B2
Chester, PA 19013-1569

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
OP007894PAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blessed With the Best Care Current Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1952700262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 RENSHAW RD APT B2",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190131569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 RENSHAW RD APT B2",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190131569",
            "telephone_number": "717-208-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "LATISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP007894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.