Active NPI
Brooke Labossiere
- Occupational Therapist
- Forestdale, MA
National Provider Identifier
1114476686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12519
- Practice address
- 337 Cotuit Rd
Forestdale, MA 02644 - Phone
- (508) 833-1060
- NPI assigned
- Sep 26, 2016
- Last updated
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 115142 | AK | |
| Occupational Therapist | 225X00000X | 12519 | MA | Primary |
Addresses
Primary practice location
337 Cotuit Rd
Forestdale, MA 02644
Mailing address
12110 Business Blvd
Ste 6 PMB 413
Eagle River, AK 99577-7741
Phone (907) 317-9349
Other practice location 1
12812 Old Glenn Hwy
Ste A5
Eagle River, AK 99577-7002
Phone (907) 317-9349
Other practice location 2
66 Mendell Rd
Rochester, MA 02770-2001
Phone (207) 745-4367
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12519 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 115142 | AK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1114476686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12110 BUSINESS BLVD",
"address_2": "STE 6 PMB 413",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777741",
"telephone_number": "907-317-9349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 COTUIT RD",
"city": "FORESTDALE",
"state": "MA",
"postal_code": "02644",
"telephone_number": "508-833-1060"
}
],
"practiceLocations": [
{
"address_1": "12812 Old Glenn Hwy",
"address_2": "Ste A5",
"address_purpose": "LOCATION",
"city": "Eagle River",
"state": "AK",
"postal_code": "995777002",
"country_code": "US",
"telephone_number": "907-317-9349",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "66 Mendell Rd",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MA",
"postal_code": "027702001",
"country_code": "US",
"telephone_number": "207-745-4367",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LABOSSIERE",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-26",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "115142",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "12519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forestdale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.