Active NPI
John Boylan, COTA MFDC
- Occupational Therapy Assistant
- Accident, MD
National Provider Identifier
1124580667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4796
- Practice address
- 116 Accident Bittinger Rd
Accident, MD 21520-1312 - Phone
- (540) 359-1985
- NPI assigned
- Apr 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 4796 | CA | Primary |
Addresses
Primary practice location
116 Accident Bittinger Rd
Accident, MD 21520-1312
Mailing address
116 Accident Bittinger Rd
Accident, MD 21520-1312
Phone (540) 359-1985
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1124580667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 ACCIDENT BITTINGER RD",
"city": "ACCIDENT",
"state": "MD",
"postal_code": "215201312",
"telephone_number": "540-359-1985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 ACCIDENT BITTINGER RD",
"city": "ACCIDENT",
"state": "MD",
"postal_code": "215201312",
"telephone_number": "540-359-1985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLAN",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "COTA MFDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-03",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "4796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Accident, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.