=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649651449
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA S CHAPPELL OTR/L
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2015
-----------------------------------------------------
Last Update Date | 04/14/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9255 US HIGHWAY 42
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41091-7199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-270-5276
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1895 WOODWARD CT
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41091-8090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-270-5276
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 008848
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 163418
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------