Sherry M Boothby, OTRL
Individual provider Active NPI Occupational Therapist · Cape Elizabeth, ME
NPI 1366471120 · NPPES record last updated Oct 8, 2018
Key facts
- NPI
- 1366471120
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT569 (ME)
- Practice address
- 2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107 - Phone
- (207) 767-9773
- Fax
- (207) 415-9212
- NPI assigned
- Jul 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT569 | ME | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Iris Network | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT569 | ME | Yes |
Addresses
Primary practice location
2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107
Mailing address
2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107-2628
Phone (207) 767-9773
Other practice location 1
189 Park Ave
Portland, ME 04102-2909
Phone (207) 774-6273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME135101 | Other | ME | MEDICARE PTAN |
Other providers in Cape Elizabeth, ME
- Sharon K Balzer
- Danielle Bates
- Behavioral Health Resources Inc.
- Monique Bellevue
- Stephen Blattner
- Boulos Psychological Services LLC
- Jayne Boulos
- Rian Branch
- Carl E Bredenberg Jr.
- Amanda Marie Brown
All providers in Cape Elizabeth, ME · Occupational Therapist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.