Carol Jean Duffy, OTR/L, MA ABS

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

014389 Issued in NY

Practice address

1823 Holcomb St
Temporary
Port Townsend, WA 98368-6034

Phone

(360) 379-0705

Fax

(360) 343-0540

NPI assigned

Sep 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Carol J Duffy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Occupational Performance Consultants

  • Occupational Therapist
  • Port Townsend, WA
  • NPI 1659554467
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1346435203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 HOLCOMB ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686034",
            "telephone_number": "360-379-0705",
            "fax_number": "360-343-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 HOLCOMB ST",
            "address_2": "TEMPORARY",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686034",
            "telephone_number": "360-379-0705",
            "fax_number": "360-343-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "OTR/L, MA ABS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014389",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT00002944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "39-1543338",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF THE STATE OF NEW YORK OFFICE OF THE PROFESSIONS",
            "identifier": "014389-1  6766087",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "3915DU",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS HEALTH PLAN",
            "identifier": "391543338-01",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR AND INDUSTR",
            "identifier": "0163787",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "DUFFY",
            "middle_name": "J",
            "credential": "OTR/L, MA ABS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Occupational Therapist in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.