Active NPI
Crystal Ann Goodrich, OT
- Pediatric Occupational Therapist
- Springvale, ME
National Provider Identifier
1003028994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 1010
- Practice address
- 469 Main Street
Suite 102
Springvale, ME 04083 - Phone
- (207) 324-2888
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT1010 | ME | |
| Pediatric Occupational Therapist | 225XP0200X | 1010 | ME | Primary |
Addresses
Primary practice location
469 Main Street
Suite 102
Springvale, ME 04083
Mailing address
3 School Street
Unit 204
Berwick, ME 03901
Phone (207) 616-8241
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT1010 | ME | MD | Occupational Therapist |
| 1010 | ME | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1003028994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SCHOOL STREET",
"address_2": "UNIT 204",
"city": "BERWICK",
"state": "ME",
"postal_code": "03901",
"telephone_number": "207-616-8241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "469 MAIN STREET",
"address_2": "SUITE 102",
"city": "SPRINGVALE",
"state": "ME",
"postal_code": "04083",
"telephone_number": "207-324-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "CRYSTAL",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT1010",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ME",
"license": "1010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springvale, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.