Individual provider Active NPI

Calli O'Connor

  • Occupational Therapy Assistant
  • Canton, MS
National Provider Identifier
1992167944
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3063 Issued in MS
Practice address
1421 E Peace St
Canton, MS 39046-4938
Phone
(601) 855-2560
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3063 MS Primary

Addresses

Primary practice location

1421 E Peace St
Canton, MS 39046-4938

Mailing address

4109 Highway 98 W
Summit, MS 39666-9132
Phone (601) 276-3900

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

LicenseStateTypeSpecialty
3063MSMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1992167944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 HIGHWAY 98 W",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396669132",
            "telephone_number": "601-276-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464938",
            "telephone_number": "601-855-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "CALLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "3063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.