Megan Phennicie, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OP008922 Issued in PA

Practice address

208 Pennknoll Rd
Everett, PA 15537-6940

Phone

(814) 623-3200

NPI assigned

Jan 4, 2018

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Megan Thomas Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2018.

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1972010544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SHOUP ST",
            "city": "SAXTON",
            "state": "PA",
            "postal_code": "166781036",
            "telephone_number": "814-494-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PENNKNOLL RD",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155376940",
            "telephone_number": "814-623-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHENNICIE",
        "first_name": "MEGAN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP008922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "THOMAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sherri Peeler, CERTIFIED DOULA
• Pennknoll Village Facility Operations, LLC
• Pennwood Ophthalmic Associates, PC
• Makenzie Beth Persun
• Kathleen Ann Petrullo, MT-BC
• Lucetta Pontiff, PHARMD
• Joyce Elaine Poydence, MA, CCC-SLP
• Prodigy Dialysis
• Gregory Wynn Pyle, DMD
• Nancy Defibaugh Pyle, CRNP

• All providers in Everett, PA
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.