Active NPI
Mallory A Geoghegan, OTR/L
- Occupational Therapist
- Hamilton, OH
National Provider Identifier
1124845698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT013042
- Practice address
- 2171 Bridgeport Dr
Hamilton, OH 45013-5193 - Phone
- (513) 868-5580
- NPI assigned
- Sep 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | OT013042 | OH | Primary |
Addresses
Primary practice location
2171 Bridgeport Dr
Hamilton, OH 45013-5193
Mailing address
400 N Erie Hwy
Hamilton, OH 45011-4263
Phone (513) 887-3710
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 |
|---|---|---|---|
| OT013042 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1124845698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N ERIE HWY",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450114263",
"telephone_number": "513-887-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2171 BRIDGEPORT DR",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450135193",
"telephone_number": "513-868-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEOGHEGAN",
"first_name": "MALLORY",
"middle_name": "A",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT013042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.