Individual provider Active NPI

Kendall Dolan, OTR/L

  • Occupational Therapist
  • Westbrook, ME
National Provider Identifier
1154199131
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT4557 Issued in ME
Practice address
123 Andover Rd
Westbrook, ME 04092-3850
Phone
(206) 661-6173
NPI assigned
Dec 19, 2023
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4557 ME Primary

Addresses

Primary practice location

123 Andover Rd
Westbrook, ME 04092-3850

Mailing address

123 Andover Rd
Westbrook, ME 04092-3850
Phone (206) 661-6173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212003849 ME Practitioner - Other (Non-Physician) 4688017171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT4557MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2024 Accepting new patients
Mainehealth CurrentSince Jan 1, 2024 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1154199131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923850",
            "telephone_number": "206-661-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923850",
            "telephone_number": "206-661-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "KENDALL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.