Individual provider Active NPI

Stephanie Dorgan, OTR/L

  • Pediatric Occupational Therapist
  • Little Falls, NJ
National Provider Identifier
1245896570
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
46TR00870600 Issued in NJ
Practice address
163 E Main St
Little Falls, NJ 07424-1711
Phone
(973) 339-0141
NPI assigned
May 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 46TR00870600 NJ Primary

Addresses

Primary practice location

163 E Main St
Little Falls, NJ 07424-1711

Mailing address

70 Boonstra Dr
Wayne, NJ 07470-2528
Phone (973) 800-3670

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46TR00870600NJMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1245896570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BOONSTRA DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702528",
            "telephone_number": "973-800-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 E MAIN ST",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241711",
            "telephone_number": "973-339-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORGAN",
        "first_name": "STEPHANIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00870600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.