Active NPI
Erin Kathleen Nilsson, OTR/L
- Occupational Therapist
- Havertown, PA
National Provider Identifier
1174149884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC016903
- Practice address
- 109 Ivy Rock LN
Havertown, PA 19083-2825 - Phone
- (484) 639-3075
- NPI assigned
- Jun 18, 2020
- 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 Therapist | 225X00000X | OC016903 | PA | Primary |
Addresses
Primary practice location
109 Ivy Rock LN
Havertown, PA 19083-2825
Mailing address
109 Ivy Rock LN
Havertown, PA 19083-2825
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 |
|---|---|---|---|
| OC016903 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1174149884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 IVY ROCK LN",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 IVY ROCK LN",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832825",
"telephone_number": "484-639-3075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILSSON",
"first_name": "ERIN",
"middle_name": "KATHLEEN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-18",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC016903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.