Active NPI
Samantha Gauvin, COTA/L
- Occupational Therapy Assistant
- Cambridge, MA
National Provider Identifier
1154871440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 55054
- Practice address
- 11 Lawrence St
Apt 2
Cambridge, MA 02139 - Phone
- (401) 480-5067
- NPI assigned
- Oct 11, 2016
- 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 | 55054 | MA | Primary |
Addresses
Primary practice location
11 Lawrence St
Apt 2
Cambridge, MA 02139
Mailing address
11 Lawrence St
Apt 2
Cambridge, MA 02139
Phone (401) 480-5067
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 |
|---|---|---|---|
| 55054 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1154871440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 LAWRENCE ST",
"address_2": "APT 2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "401-480-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 LAWRENCE ST",
"address_2": "APT 2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "401-480-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUVIN",
"first_name": "SAMANTHA",
"name_prefix": "Miss",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-11",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "55054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.