Active NPI
Bridget Marie Pettiford, OTR/L
- Occupational Therapist
- Columbia, MD
National Provider Identifier
1205093135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 05068
- Practice address
- 6336 Cedar LN
Columbia, MD 21044-3897 - Phone
- (410) 531-6000
- Fax
- (410) 531-3402
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 05068 | MD | Primary |
Addresses
Primary practice location
6336 Cedar LN
Columbia, MD 21044-3897
Mailing address
200 Northpointe Cir
Ste. 302
Seven Fields, PA 16046-7861
Phone (800) 815-8577
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05068 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1205093135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NORTHPOINTE CIR",
"address_2": "STE. 302",
"city": "SEVEN FIELDS",
"state": "PA",
"postal_code": "160467861",
"telephone_number": "800-815-8577",
"fax_number": "724-779-6407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6336 CEDAR LN",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210443897",
"telephone_number": "410-531-6000",
"fax_number": "410-531-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIFORD",
"first_name": "BRIDGET",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "05068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.