Individual provider Active NPI

Carolyn Ray

  • Occupational Therapy Assistant
  • Greenwood, IN
National Provider Identifier
1962521161
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32000664A Issued in IN
Practice address
3100 Meridian Parke Dr Ste N PMB 159
Greenwood, IN 46142-9424
Phone
(317) 502-6366
Fax
(317) 888-4680
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 32000664A IN Primary

Addresses

Primary practice location

3100 Meridian Parke Dr Ste N PMB 159
Greenwood, IN 46142-9424

Mailing address

3100 Meridian Parke Dr Ste N PMB 159
Greenwood, IN 46142-9424
Phone (317) 502-6366

Other identifiers 2

IdentifierTypeStateIssuer
200720700 AOtherINPROVIDER NUMBER FOR FIRST
200720700 AOtherINFIRST STEP PROVIDER #

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
32000664AINMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962521161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MERIDIAN PARKE DR STE N PMB 159",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429424",
            "telephone_number": "317-502-6366",
            "fax_number": "317-888-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MERIDIAN PARKE DR STE N PMB 159",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429424",
            "telephone_number": "317-502-6366",
            "fax_number": "317-888-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32000664A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER FOR FIRST",
            "identifier": "200720700 A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEP PROVIDER #",
            "identifier": "200720700 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.