Paul Martin Bagnell, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131-001616 Issued in VA

Practice address

4920 Woodmar Dr SW
Roanoke, VA 24018-1651

Phone

(540) 400-0897

NPI assigned

Jul 12, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1285086454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 CIRCLE BROOK DR APT L",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188214",
            "telephone_number": "703-853-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 WOODMAR DR SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181651",
            "telephone_number": "540-400-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNELL",
        "first_name": "PAUL",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131-001616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Baetz, M.D.
• Anthony William Baffoe-Bonnie, M.D.
• Kathleen T. Bagby, LCSW
• Robin Elizabeth Bagby, D.D.S.
• Bagla LLC
• Kumar D Bahl, MD
• Gurlal Singh Baidwan, D.O.
• Carrie A Bailes, MD
• Benjamin Bailey
• Dewey James Bailey III, MD

• Occupational Therapy Assistant in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.