Amanda Marie Gannon, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

016997-1 Issued in NY

Practice address

597 3Rd Ave
Troy, NY 12182-2509

Phone

(518) 233-0703

NPI assigned

Nov 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Amanda Marie Schroeder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1366719759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 DIVISION ST",
            "city": "CHARLTON",
            "state": "NY",
            "postal_code": "120192907",
            "telephone_number": "518-424-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 3RD AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121822509",
            "telephone_number": "518-233-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016997-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SCHROEDER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "MS OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Gabriel
• William Christopher Gallo, DC
• Karen M Galluccio-Mott
• Tanisha Gang
• Denise Catherine Gangi-Pollacek, RPA-C
• Tyler Scott Gannon, PHARMD, RPH
• Frank Farrell Garcia, MD
• Karin Gardner, MSW, LICSW, LCSW
• Colin Gauert
• Catherine Ann Gayron, LCSW

• Occupational Therapist in Troy, NY
• Providers in Troy, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.