Active NPI
Stephanie Braudrick, OTR/L, LMT
- Occupational Therapist
- Skaneateles Falls, NY
National Provider Identifier
1366099855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 023874
- Practice address
- 4652 Jordan Rd
Skaneateles Falls, NY 13153-7704 - Phone
- (315) 857-5843
- NPI assigned
- Aug 20, 2019
- 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 | 023874 | NY | Primary |
Addresses
Primary practice location
4652 Jordan Rd
Skaneateles Falls, NY 13153-7704
Mailing address
PO Box 119
Skaneateles Falls, NY 13153-0119
Phone (315) 857-5843
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1366099855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 119",
"city": "SKANEATELES FALLS",
"state": "NY",
"postal_code": "131530119",
"telephone_number": "315-857-5843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4652 JORDAN RD",
"city": "SKANEATELES FALLS",
"state": "NY",
"postal_code": "131537704",
"telephone_number": "315-857-5843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAUDRICK",
"first_name": "STEPHANIE",
"credential": "OTR/L, LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "023874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skaneateles Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.