Charles C Barnes – Occupational Therapy Assistant

Key facts

NPI: 1992003198
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapy Assistant 224Z00000X
License: 2023182 (TX)
Practice address: 389 Leisure World
Mesa, AZ 85206-3148
Phone: (480) 985-5760
NPI assigned: Mar 11, 2011
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2023182	TX	MD	Occupational Therapy Assistant
0210A	AZ	MD	Physical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapy Assistant	224Z00000X	2023182	TX	Yes
Physical Therapy Assistant	225200000X	0210A	AZ
Physical Therapy Assistant	225200000X	7654	OR

Addresses

Primary practice location

389 Leisure World
Mesa, AZ 85206-3148

Mailing address

389 Leisure World
Mesa, AZ 85206-3148

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 11, 2011.

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1992003198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 LEISURE WORLD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 LEISURE WORLD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063148",
            "telephone_number": "480-985-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "CHARLES",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "2023182",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "0210A",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "7654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

All providers in Mesa, AZ · Occupational Therapy Assistant in Arizona

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.