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1700695020 NPI number — REGAN TRIPPE BOOKER OTR-L

NPI Number: 1700695020
Health Care Provider/Practitioner: REGAN TRIPPE BOOKER OTR-L

Information about “1700695020” NPI (REGAN TRIPPE BOOKER OTR-L) exists in 1700695020 in HTML format HTML  |  1700695020 in plain Text format TXT  |  1700695020 in PDF (Portable Document Format) PDF  |  1700695020 in an XML format XML  formats.

NPI Number : 1700695020 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700695020",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOOKER",
    "FirstName": "REGAN",
    "MiddleName": "TRIPPE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTR-L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3443 W SANDS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85027-1640",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "636-328-8178",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1919 E THOMAS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85016-7710",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-933-1000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/01/2025",
    "LastUpdateDate": "01/06/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "OTH-009594",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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