John Lewis Balsamo, O.T.R

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00339000 Issued in NJ

Practice address

1 Boone Rd
Bremerton, WA 98312-1894

Phone

(360) 475-5301

NPI assigned

Dec 5, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1225306244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121894",
            "telephone_number": "360-475-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSAMO",
        "first_name": "JOHN",
        "middle_name": "LEWIS",
        "credential": "O.T.R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00339000",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "TX",
            "license": "117189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy L Baldwin, MD
• Samantha Baldwin
• Jacob Wayne Ballard
• Rachel Ballard
• Elena Balsalobre
• Adam James Banker, D.C.
• Bertha Mae Banks, LPN
• Gilbert E Banks, MSW
• Jessie Michelle Banks, DDS
• Mary Banks, LMP

• Occupational Therapist in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.