Active NPI
Patrica Diane Elliott
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1972086098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3988
- Practice address
- 600 Camino Espanol NW
Albuquerque, NM 87107-5817 - Phone
- (505) 250-5204
- NPI assigned
- Sep 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3988 | NM | Primary |
Addresses
Primary practice location
600 Camino Espanol NW
Albuquerque, NM 87107-5817
Mailing address
280 Trosello Rd
Corrales, NM 87048-6104
Phone (907) 617-5216
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3988 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LSG and Associates LLC | Past | Accepting new patients | |
| LSG and Associates Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Albuquerque, NM
- NPI 1306482120
-
- Developmentally Disabled Services Day Training Agency
- Albuquerque, NM
- NPI 1750701462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536796800000",
"number": "1972086098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 TROSELLO RD",
"city": "CORRALES",
"state": "NM",
"postal_code": "870486104",
"telephone_number": "907-617-5216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 CAMINO ESPANOL NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871075817",
"telephone_number": "505-250-5204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "PATRICA",
"middle_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-13",
"last_updated": "2018-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "3988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.