NPIMap

Individual provider Active NPI

Mary Catherine Noonan, OTR

  • Occupational Therapist
  • Peabody, MA
National Provider Identifier
1013431295
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
322101 Issued in LA
Practice address
96 Forest St
Peabody, MA 01960-3907
Phone
(978) 532-0303
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 12378 MA
Occupational Therapist 225X00000X 322101 LA Primary

Addresses

Primary practice location

96 Forest St
Peabody, MA 01960-3907

Mailing address

4104 N Turnbull Dr
Metairie, LA 70002-4438
Phone (504) 266-5501

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
322101LAMDOccupational Therapist
12378MAMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1013431295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 N TURNBULL DR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024438",
            "telephone_number": "504-266-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 FOREST ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603907",
            "telephone_number": "978-532-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12378",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "322101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.