Individual provider Active NPI

Mary Patricia Jodoin, OTR

  • Occupational Therapist
  • Wilmington, DE
National Provider Identifier
1336267517
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
U1-0000960 Issued in DE
Practice address
810 S Broom St
Wilmington, DE 19805-4245
Phone
(302) 652-1181
NPI assigned
Mar 27, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46 TR 00276500 NJ
Occupational Therapist 225X00000X 06408 MD
Occupational Therapist 225X00000X U1-0000960 DE Primary

Addresses

Primary practice location

810 S Broom St
Wilmington, DE 19805-4245

Mailing address

810 S Broom St
Wilmington, DE 19805-4245

Other practice location 1

505 Greenbank Rd
Wilmington, DE 19808-3164
Phone (302) 998-0101

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
06408MDMDClinical Social Worker
U1-0000960DEMDOccupational Therapist
46 TR 00276500NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336267517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S BROOM ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S BROOM ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054245",
            "telephone_number": "302-652-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Greenbank Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198083164",
            "country_code": "US",
            "telephone_number": "302-998-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JODOIN",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46 TR 00276500",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06408",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DE",
            "license": "U1-0000960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.