Individual provider Active NPI

Emily J. Berlin, OTR/L

  • Specialist
  • Marlton, NJ
National Provider Identifier
1073609947
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
46TR00207300 Issued in NJ
Practice address
3001 Lincoln Dr W
Suite I
Marlton, NJ 08053-1528
Phone
(856) 396-3173
Fax
(856) 396-0063
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 46TR00207300 NJ Primary

Addresses

Primary practice location

3001 Lincoln Dr W
Suite I
Marlton, NJ 08053-1528

Mailing address

3001 Lincoln Dr W
Suite I
Marlton, NJ 08053-1528
Phone (856) 396-3173

Other identifiers 2

IdentifierTypeStateIssuer
1430551OtherNJUNITEDHEALTHCARE MPIN
3772251OtherNJCIGNA PPO PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607001075 NJ Practitioner - Occupational Therapist in Private Practice 6305828856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Rehab LLC CurrentSince Apr 15, 2008 Accepting new patients

Locations

807 N Haddon Ave
Ste 1
Haddonfield, NJ 08033
Phone (856) 330-6260

801 Route 73 N
Ste G
Marlton, NJ 08053
Phone (856) 396-3173

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1073609947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 LINCOLN DR W",
            "address_2": "SUITE I",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531528",
            "telephone_number": "856-396-3173",
            "fax_number": "856-396-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LINCOLN DR W",
            "address_2": "SUITE I",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531528",
            "telephone_number": "856-396-3173",
            "fax_number": "856-396-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "EMILY",
        "middle_name": "J.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "46TR00207300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE MPIN",
            "identifier": "1430551",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO PROVIDER ID",
            "identifier": "3772251",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.