Earth Angels Therapy, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

0311 Issued in AZ

Legal business name

EARTH ANGELS THERAPY, LLC

Practice address

10101 N 91St Ave
#112
Peoria, AZ 85345-8335

Phone

(623) 521-5387

Fax

(866) 896-0786

NPI assigned

Sep 24, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Nancy Ann Palatnik, OTR/L

Title

Owner

Phone

(623) 521-5387

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Ann Pfefferkorn, OTR/L

  • Occupational Therapist
  • Rimrock, AZ
  • NPI 1801068721
  NPD (past)

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1972603454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 N 91ST AVE",
            "address_2": "#112",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458335",
            "telephone_number": "623-521-5387",
            "fax_number": "866-896-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 N 91ST AVE",
            "address_2": "#112",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458335",
            "telephone_number": "623-521-5387",
            "fax_number": "866-896-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH ANGELS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "PALATNIK",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-521-5387",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "0311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER",
            "identifier": "987688",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.