Brenda Sue Baynham, OTR/L

Key facts

NPI

1407124696

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

0119001273 (VA)

Practice address

540 Aberthaw Ave
Newport News, VA 23601-4103

Phone

(757) 595-1946

Fax

(757) 595-3238

NPI assigned

Dec 2, 2011

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2011.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1407124696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 WILMONT LN",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236083226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 ABERTHAW AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236014103",
            "telephone_number": "757-595-1946",
            "fax_number": "757-595-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYNHAM",
        "first_name": "BRENDA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119001273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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