Active NPI
Mary Beth Merola, OTR
- Occupational Therapist
- Atascadero, CA
National Provider Identifier
1134346208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10541
- Practice address
- 631 Buena Fortuna Cir
Atascadero, CA 93422-8860 - Phone
- (805) 886-3717
- NPI assigned
- Apr 19, 2007
- Last updated
- Aug 18, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10541 | CA | Primary |
Addresses
Primary practice location
631 Buena Fortuna Cir
Atascadero, CA 93422-8860
Mailing address
PO Box 5015
San Luis Obispo, CA 93403-5015
Phone (805) 886-3717
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10541 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1134346208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5015",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934035015",
"telephone_number": "805-886-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 BUENA FORTUNA CIR",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934228860",
"telephone_number": "805-886-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEROLA",
"first_name": "MARY BETH",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "10541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atascadero, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.