Individual provider Active NPI

Emily Carrick, OTR/L

  • Occupational Therapist
  • Waterboro, ME
National Provider Identifier
1366279515
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT4726 Issued in ME
Practice address
392 Main St
Waterboro, ME 04087-3057
Phone
(207) 247-3216
NPI assigned
Sep 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4726 ME Primary

Addresses

Primary practice location

392 Main St
Waterboro, ME 04087-3057

Mailing address

47 Barberry Creek Rd
South Portland, ME 04106-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030003390 ME Practitioner - Occupational Therapist in Private Practice 8921531807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massabesic Health Resources PAGroup PAC ID 5395712137, 12 clinicians

Practice addresses (Care Compare)

392 Main St
Waterboro, ME 04087-3057
Phone (207) 247-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massabesic Health Resources PA CurrentSince Sep 20, 2024 Accepting new patients

Locations

392 Main St
Waterboro, ME 04087
Phone (207) 347-3216

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1366279515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BARBERRY CREEK RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 MAIN ST",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "040873057",
            "telephone_number": "207-247-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRICK",
        "first_name": "EMILY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterboro, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.