NPIMap

Organization Active NPI

Bayside Children's Therapy Network, Inc.

  • Pediatric Occupational Therapist
  • Gloucester, VA
National Provider Identifier
1184938003
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0119004244 Issued in VA
Legal business name
BAYSIDE CHILDREN'S THERAPY NETWORK, INC.
Practice address
6688 Main St
Gloucester, VA 23061-5194
Phone
(804) 210-1555
NPI assigned
Aug 3, 2010
Last updated
Sep 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Authorized official

Name
Lisa McCann, MA, OTRNPI 1811171028
Title
President, OT
Phone
(804) 210-1555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2305000705 VA
Pediatric Occupational Therapist 225XP0200X 0119004244 VA Primary
Speech-Language Pathologist 235Z00000X 2202003940 VA

Addresses

Primary practice location

6688 Main St
Gloucester, VA 23061-5194

Mailing address

PO Box 130
Gloucester, VA 23061-0130
Phone (804) 210-1555

National Provider Directory

National Provider Directory

Locations

6688 Main St
Gloucester, VA 23061
Phone (804) 210-1555

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": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1184938003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230610130",
            "telephone_number": "804-210-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6688 MAIN ST",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230615194",
            "telephone_number": "804-210-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE CHILDREN'S THERAPY NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT, OT",
        "authorized_official_telephone_number": "804-210-1555",
        "authorized_official_credential": "MA, OTR"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305000705",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119004244",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.