Active NPI
Kendra Edozie, M.S.
- Occupational Therapist
- Upper Marlboro, MD
National Provider Identifier
1336654490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 18143
- Practice address
- 7713 Presidential Pkwy
Upper Marlboro, MD 20774-2693 - Phone
- (925) 918-0789
- NPI assigned
- Dec 11, 2017
- Last updated
- Jun 27, 2023
- 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 Therapist | 225X00000X | 18143 | CA | Primary |
Addresses
Primary practice location
7713 Presidential Pkwy
Upper Marlboro, MD 20774-2693
Mailing address
7713 Presidential Pkwy
Upper Marlboro, MD 20774-2693
Phone (925) 918-0789
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy at Play, Inc | Past | Accepting new patients |
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.
-
- Pediatric Occupational Therapist
- San Ramon, CA
- NPI 1326379298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1336654490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7713 PRESIDENTIAL PKWY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207742693",
"telephone_number": "925-918-0789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7713 PRESIDENTIAL PKWY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207742693",
"telephone_number": "925-918-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDOZIE",
"first_name": "KENDRA",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-11",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "18143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.