Active NPI
Kenneth Bureau, OT
- Occupational Therapist
- Augusta, ME
National Provider Identifier
1134820871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT4419
- Practice address
- 15 Enterprise Dr
Augusta, ME 04330-7997 - Phone
- (207) 621-7500
- NPI assigned
- Mar 10, 2023
- 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 Therapist | 225X00000X | OT4419 | ME | Primary |
Addresses
Primary practice location
15 Enterprise Dr
Augusta, ME 04330-7997
Mailing address
15 Enterprise Dr
Augusta, ME 04330-7997
Phone (207) 621-7500
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 |
|---|---|---|---|
| OT4419 | ME | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678406400000",
"number": "1134820871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 ENTERPRISE DR",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043307997",
"telephone_number": "207-621-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 ENTERPRISE DR",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043307997",
"telephone_number": "207-621-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUREAU",
"first_name": "KENNETH",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-10",
"last_updated": "2023-03-10",
"certification_date": "2023-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT4419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.