NPIMap

Organization Active NPI

Southern Maine Pediatric Therapies, PLLC

  • Occupational Therapist
  • Gorham, ME
National Provider Identifier
1174867576
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1187 Issued in ME
Legal business name
SOUTHERN MAINE PEDIATRIC THERAPIES, PLLC
Practice address
14 Murray Drive
Gorham, ME 04038
Phone
(207) 233-7373
Fax
(888) 731-2721
NPI assigned
Nov 26, 2012
Last updated
Nov 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Mrs. Susanne L Martorano, OTR/L
Title
Owner
Phone
(207) 233-7373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X OT1187 ME Primary

Addresses

Primary practice location

14 Murray Drive
Gorham, ME 04038

Mailing address

14 Murray Drive
Gorham, ME 04038
Phone (207) 233-7373

National Provider Directory

National Provider Directory
Tax ID family
Southern Maine Pediatric Therapies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 Trails End Rd
Windham, ME 04062
Phone (207) 233-7373

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1174867576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MURRAY DRIVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "04038",
            "telephone_number": "207-233-7373",
            "fax_number": "888-731-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MURRAY DRIVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "04038",
            "telephone_number": "207-233-7373",
            "fax_number": "888-731-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MAINE PEDIATRIC THERAPIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "MARTORANO",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-233-7373",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT1187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.