Tyler V Bohanan, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

A02545 Issued in MD

Practice address

2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123

Phone

(410) 515-4900

Fax

(410) 515-0777

NPI assigned

Feb 27, 2019

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Maryland Therapy Network, Inc

  • Speech-Language Pathologist
  • Bel Air, MD
  • NPI 1770611394
  NPD (past)

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1063979912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 SPADE RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443439",
            "telephone_number": "410-515-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 OLD EMMORTON RD STE 210",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156123",
            "telephone_number": "410-515-4900",
            "fax_number": "410-515-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANAN",
        "first_name": "TYLER",
        "middle_name": "V",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419800000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel K Blumenthal, MS, LGPC
• Clara Bobo
• Amy Joann Boccia, MAC
• Preston Robert Bodison II, PH.D.
• Jonathan Maxwell Bodner, MD
• Olayiwola Akeem Bolaji, MD
• Amanda Jane Bolen, MA, LGPC
• Zechariah G Bolick, LPCMH
• Matthew Carroll Bollinger
• Alyssa Boltz

• All providers in Bel Air, MD
• Occupational Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.