Andrea M O'Brien, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

132611 Issued in KY

Practice address

4504 Starlite LN
Louisville, KY 40291-1725

Phone

(502) 930-6064

NPI assigned

Apr 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other names 1

• Ms. Andrea Michelle Maddux 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": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1083102685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 STARLITE LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911725",
            "telephone_number": "502-930-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4504 STARLITE LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911725",
            "telephone_number": "502-930-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-29",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "132611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MADDUX",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victor I Nwosu
• Nyan & Associates, PSC
• John Aaron Nyland, DPT, SCS, EDD., ATC
• Jacques Nzabonimpa
• L. David O'Banion, D.M.D.
• Celia M O'Brien, M.D.
• Daniel J O'Brien, M.D.
• Emily O'Brien
• Emily Isabella O'Brien, APRN
• Harold Dean O'Brien, APRN

• Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.