Active NPI
Brandi Gordon, COTA/L
- Occupational Therapy Assistant
- Baltimore, MD
National Provider Identifier
1265733380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- AO1552
- Practice address
- 4803 Aberdeen Ave
Baltimore, MD 21206-6935 - Phone
- (410) 878-7835
- NPI assigned
- Nov 4, 2010
- 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 Therapy Assistant | 224Z00000X | AO1552 | MD | Primary |
Addresses
Primary practice location
4803 Aberdeen Ave
Baltimore, MD 21206-6935
Mailing address
4803 Aberdeen Ave
Baltimore, MD 21206-6935
Phone (410) 878-7835
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
| License | State | Type | Specialty |
|---|---|---|---|
| AO1552 | MD | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1265733380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4803 ABERDEEN AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212066935",
"telephone_number": "410-878-7835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4803 ABERDEEN AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212066935",
"telephone_number": "410-878-7835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "BRANDI",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-04",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "AO1552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.