Madison Nicole Eberlin, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC017687 Issued in PA

Practice address

91 Hospital Dr
Towanda, PA 18848-9702

Phone

(570) 265-2191

NPI assigned

Sep 21, 2022

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Sep 21, 2022.

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1225751522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 HOSPITAL DR",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188489702",
            "telephone_number": "570-265-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 HOSPITAL DR",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188489702",
            "telephone_number": "570-265-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLIN",
        "first_name": "MADISON",
        "middle_name": "NICOLE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Towanda, PA
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.