Individual provider Active NPI

Alexis Cooper, COTA

  • Occupational Therapy Assistant
  • Gilbert, AZ
National Provider Identifier
1962052555
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-000052 Issued in AZ
Practice address
854 E Williams Field Rd Ste 105
Gilbert, AZ 85295-0703
Phone
(480) 398-4280
Fax
(480) 398-4281
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 OTA-000052 AZ Primary

Addresses

Primary practice location

854 E Williams Field Rd Ste 105
Gilbert, AZ 85295-0703

Mailing address

1739 S Almond
Mesa, AZ 85204-6905
Phone (208) 745-1971

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
OTA-000052AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piller Child Development LLC PastSince Sep 25, 2019 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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1962052555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 S ALMOND",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046905",
            "telephone_number": "208-745-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 E WILLIAMS FIELD RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950703",
            "telephone_number": "480-398-4280",
            "fax_number": "480-398-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ALEXIS",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-000052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.