CMS-1500 Box 24J / 33a • NPI
1417358987
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
225X00000X (CMS 67)
Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)
Box 32 Service Location & ZIP+4
2300 N BROADWAY ST, POTEAU, OK, 74953
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1417358987 (AMY CATHLEEN FERGUSON, MOT, OTR/L) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1417358987 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AMY CATHLEEN FERGUSON, MOT, OTR/L |
| Plain-English Specialty | Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) NUCC Code: 225X00000X (Occupational Therapist) |
| Certifying / Licensing Body | National Board for Certification in Occupational Therapy (NBCOT) |
| Practice Location Address | 2300 N BROADWAY ST, POTEAU, OK, 74953 |
| Practice Telephone / Fax | Tel: (918) 962-0198 | Fax: (844) 632-7298 |
| Administrative Mailing Address | 41116 E COUNTY ROAD 1240, KEOTA, OK, 74941-6451 |
| Enumeration & Last Sync | Enumerated: 2014-09-15 | CMS Record Updated: 2018-08-21 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (225X00000X)
What Does Taxonomy Code 225X00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225X00000X translates to:
"Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMY CATHLEEN FERGUSON, MOT, OTR/L)
Typical CPT / Diagnostic Procedures:- Activities of Daily Living (ADL) & Neuromuscular Re-Education (CPT 97530–97535)
- Upper Extremity Hand Therapy, Custom Splinting & Home Safety Ergonomics
- Non-Pharmacological Functional & Sensory-Motor Rehabilitation Protocols
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: OK | License: 1904 | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: AR | License: OTR2724 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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