Individual provider Active NPI

Mary Helen Dewitt, OCCUPATIONAL THERAPI

  • Occupational Therapy Assistant
  • Lincoln, CA
National Provider Identifier
1255410767
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5792 Issued in CA
Practice address
1530 3Rd St
Suite 211
Lincoln, CA 95648-1562
Phone
(916) 434-9572
Fax
(916) 434-9063
NPI assigned
Nov 3, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5792 CA Primary

Addresses

Primary practice location

1530 3Rd St
Suite 211
Lincoln, CA 95648-1562

Mailing address

1530 3Rd St
Suite 211
Lincoln, CA 95648-1562
Phone (916) 434-9572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040426000644 CA Practitioner - Occupational Therapist in Private Practice 2163418930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Physical and Occupational Therapy, Inc CurrentSince Jul 2, 2007 Accepting new patients

Locations

150 Gateway Dr
Ste A
Lincoln, CA 95648
Phone (916) 434-9572

1530 3rd St
Ste 211
Lincoln, CA 95648
Phone (916) 434-9572

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1255410767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 3RD ST",
            "address_2": "SUITE 211",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956481562",
            "telephone_number": "916-434-9572",
            "fax_number": "916-434-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 3RD ST",
            "address_2": "SUITE 211",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956481562",
            "telephone_number": "916-434-9572",
            "fax_number": "916-434-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "5792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.