Individual provider Active NPI

Pamela Anderson Walls, OTRL

  • Occupational Therapist
  • Ayer, MA
National Provider Identifier
1073639811
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5999 Issued in MA
Practice address
400 Groton Rd
Ayer, MA 01432-1171
Phone
(978) 784-3536
NPI assigned
Mar 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5999 MA Primary
Occupational Therapist 225X00000X OT1996 ME
Occupational Therapist 225X00000X 1876 NH

Addresses

Primary practice location

400 Groton Rd
Ayer, MA 01432-1171

Mailing address

492 Westminster Hill Rd
Fitchburg, MA 01420-2948
Phone (978) 345-0278

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
5999MAMDMental Health Counselor
OT1996MEMDOccupational Therapist
1876NHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073639811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 WESTMINSTER HILL RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014202948",
            "telephone_number": "978-345-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GROTON RD",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321171",
            "telephone_number": "978-784-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "PAMELA",
        "middle_name": "ANDERSON",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "5999",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT1996",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "1876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ayer, MA

Sources for this page

  • 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.