Individual provider Active NPI

Laurel Ann Taylor, OTR/L

  • Occupational Therapist
  • Parkville, MD
National Provider Identifier
1104667658
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
06981 Issued in MD
Practice address
8820 Walther Blvd
Parkville, MD 21234-9025
Phone
(410) 657-3593
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 06981 MD Primary

Addresses

Primary practice location

8820 Walther Blvd
Parkville, MD 21234-9025

Mailing address

7602 Chapman Rd
Kingsville, MD 21087-1532
Phone (443) 791-2110

Other practice location 1

9900 Walther Blvd
Parkville, MD 21234-5785
Phone (410) 449-5995

Other names 1

  • Laurel Ann Bragg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240711004291 MD Practitioner - Occupational Therapist in Private Practice 5395280507 Reassigns benefits to 1 organization
I20240711004361 DC Practitioner - Occupational Therapist in Private Practice 5395280507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

9900 Walther Blvd
Parkville, MD 21234-5785
Phone 8552393467721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06981MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc Occupational Therapist CurrentSince Jun 24, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jun 24, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jun 24, 2024 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 3

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1104667658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 CHAPMAN RD",
            "city": "KINGSVILLE",
            "state": "MD",
            "postal_code": "210871532",
            "telephone_number": "443-791-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 WALTHER BLVD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212349025",
            "telephone_number": "410-657-3593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9900 Walther Blvd",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212345785",
            "country_code": "US",
            "telephone_number": "410-449-5995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LAUREL",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "BRAGG",
            "middle_name": "ANN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.