Mary Elizabeth Craigie, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT0000002580 Issued in TN

Practice address

23 Glenwood Dr
Jackson, TN 38305-1722

Phone

(731) 664-9095

NPI assigned

May 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary Elizabeth Bertucci Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053532499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 GLENWOOD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051722",
            "telephone_number": "731-664-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 GLENWOOD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051722",
            "telephone_number": "731-664-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIGIE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT0000002580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BERTUCCI",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Brian Craddock
• Shaniece A Craft
• James T Craig Jr., MD
• Jim C Craig Jr., M.D.
• Kyle Douglas Craig, PMHNP
• Ashley Crandall, LPN
• Milton Cravens, DDS
• Carolyn Crawford, LPC
• Robyn Crawford
• Jessica Crawley, COTA

• Occupational Therapist in Jackson, TN
• Providers in Jackson, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.