Individual provider Active NPI

Mandi Emerick, COTA/L

  • Occupational Therapy Assistant
  • Frostburg, MD
National Provider Identifier
1104071463
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
A0159 Issued in MD
Practice address
1 Kaylor Cir
Frostburg, MD 21532-2009
Phone
(301) 689-7500
NPI assigned
Nov 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A0159 MD Primary

Addresses

Primary practice location

1 Kaylor Cir
Frostburg, MD 21532-2009

Mailing address

1278 Hyndman Rd
Hyndman, PA 15545-7630
Phone (814) 709-2116

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
A0159MDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1104071463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 HYNDMAN RD",
            "city": "HYNDMAN",
            "state": "PA",
            "postal_code": "155457630",
            "telephone_number": "814-709-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KAYLOR CIR",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215322009",
            "telephone_number": "301-689-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERICK",
        "first_name": "MANDI",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-28",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A0159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frostburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.