Active NPI
Brittney Edgerton, COTA/L
- Occupational Therapy Assistant
- Albuquerque, NM
National Provider Identifier
1134517899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3301
- Practice address
- 818 Menaul Blvd NW
Albuquerque, NM 87107-1245 - Phone
- (505) 980-1706
- NPI assigned
- Jan 5, 2015
- 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 Therapy Assistant | 224Z00000X | 3301 | NM | Primary |
Addresses
Primary practice location
818 Menaul Blvd NW
Albuquerque, NM 87107-1245
Mailing address
12509 Tomlinson Dr SE
Albuquerque, NM 87123-3711
Phone (505) 980-1706
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 |
|---|---|---|---|
| 3301 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1134517899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12509 TOMLINSON DR SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871233711",
"telephone_number": "505-980-1706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 MENAUL BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071245",
"telephone_number": "505-980-1706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGERTON",
"first_name": "BRITTNEY",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-05",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "3301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.