Amanda Marie Grubb, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32003383A Issued in IN

Practice address

1400 Medical Park Dr
Fort Wayne, IN 46825-5832

Phone

(260) 484-1558

NPI assigned

May 17, 2023

Last updated

May 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1982395299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83",
            "city": "MARK CENTER",
            "state": "OH",
            "postal_code": "435360083",
            "telephone_number": "574-732-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MEDICAL PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255832",
            "telephone_number": "260-484-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBB",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32003383A",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA007230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Rose Grover
• Heather Groves, MA
• Heather M Groves, RBT
• Grow Together Speech Therapy LLC
• Staci Renae Grubaugh, MA, BCBA
• Ann M. Grubb, PA
• Brian L Grubb, LSW
• Paige Grube, PHARMD
• Jeyda Delreese Gruel-Fields, RPH
• Evangeline Grunden

• Occupational Therapy Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.