Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1386100402 Individual Practitioner Female Practitioner

Ellison M Kruckenberg , COTA, L

Occupational Therapy Assistant • Bountiful, UT

Professional Overview & Biography Verified Profile Summary

Ellison Kruckenberg, COTA, L is a registered healthcare professional specializing in Occupational Therapy Assistant in Bountiful, UT. Practice services are available at 401 S 400 E under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

401 S 400 E

Bountiful, UT 840104933

Telephone 8012952361
Associated Practice Facility / Clinic
🏢 Providential Bba Operating Lp Facility NPI 1275560062

Specialty Benchmarks & Practice Insights

Comparative analytics for Occupational Therapy Assistant in Bountiful, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.0 Yrs
Regional Practice Density
7 Specialists

Practicing in Bountiful, UT (135 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-12
Occupational Therapy Assistant Primary Specialty

NUCC Taxonomy Code: 224Z00000X

State License UT 12931092-4202

An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Esther Grandy , TRS, CTRS

Recreation Therapist

NPI 1174352173
Tyler Bridgewater , FNP-C

Nurse Practitioner - Family

NPI 1215378377

Family Nurse Practitioner (Certified)

Dayna Epperson , OTR, L

Occupational Therapist

NPI 1407305154

Occupational Therapist Registered, L

Richard Hinkle , CNA, EMT

Emergency Medical Technician, Basic

NPI 1427679448

Certified Nursing Assistant, EMT

Sarah Gehrig

Occupational Therapist

NPI 1437588902
Kylie Frandsen , MOT, OTR, L

Occupational Therapist

NPI 1497506232

Master of Occupational Therapy, Occupational Therapist Registered, L

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 12, 2022

Registered at 401 S 400 E, BOUNTIFUL, UT 840104933 (Tel: 8012952361)

📍
Updated Business Mailing Address July 12, 2022

Registered at 9487 S WASATCH DOWNS CIR, SOUTH JORDAN, UT 840959289 (Tel: 3852269401)

👤
Provider Name / Credentials Updated July 12, 2022

Recorded as ELLISON KRUCKENBERG, COTA/L

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 12, 2022

Occupational Therapy Assistant (License #12931092-4202 in UT)

NPI Profile Active February 13, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location February 13, 2019

Registered at 6013 S REDWOOD RD, TAYLORSVILLE, UT 841235220 (Tel: 8012555131)

📍
Updated Business Mailing Address February 13, 2019

Registered at 6013 S REDWOOD RD, TAYLORSVILLE, UT 841235220 (Tel: 8012555131)

👤
Provider Name / Credentials Updated February 13, 2019

Recorded as ELLISON KRUCKENBERG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2019

Counselor

🟢
Initial NPI Registration & Enumeration February 13, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1386100402
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 13, 2019
Last Update: July 12, 2022
Sole Proprietor: Yes

Mailing Address

9487 S Wasatch Downs Cir

South Jordan, UT 840959289

Phone: 3852269401

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.