Active NPI
Devon Irvin, OTR/L
- Occupational Therapist
- Bowie, MD
National Provider Identifier
1174852719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 04997
- Practice address
- 1723 Stourbridge CT
Bowie, MD 20721-2776 - Phone
- (202) 320-7386
- NPI assigned
- Dec 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT00000149 | DC | |
| Occupational Therapist | 225X00000X | 04997 | MD | Primary |
Addresses
Primary practice location
1723 Stourbridge CT
Bowie, MD 20721-2776
Mailing address
1723 Stourbridge CT
Bowie, MD 20721-2776
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 |
|---|---|---|---|
| OT00000149 | DC | MD | Occupational Therapist |
| 04997 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260403200000",
"number": "1174852719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1723 STOURBRIDGE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1723 STOURBRIDGE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212776",
"telephone_number": "202-320-7386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "DEVON",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-10",
"last_updated": "2009-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "DC",
"license": "OT00000149",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "04997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.