Individual provider Active NPI

Carissa Peppard, OTR

  • Occupational Therapist
  • Effort, PA
National Provider Identifier
1992849145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC-009836 Issued in PA
Practice address
1621 Starry LN
Effort, PA 18330-9748
Phone
(570) 629-6793
Fax
(570) 424-2346
NPI assigned
Feb 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC-009836 PA Primary

Addresses

Primary practice location

1621 Starry LN
Effort, PA 18330-9748

Mailing address

1621 Starry LN
Effort, PA 18330-9748
Phone (570) 629-6793

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
OC-009836PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992849145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 STARRY LN",
            "city": "EFFORT",
            "state": "PA",
            "postal_code": "183309748",
            "telephone_number": "570-629-6793",
            "fax_number": "570-424-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 STARRY LN",
            "city": "EFFORT",
            "state": "PA",
            "postal_code": "183309748",
            "telephone_number": "570-629-6793",
            "fax_number": "570-424-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPARD",
        "first_name": "CARISSA",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC-009836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effort, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.