Individual provider Active NPI

Mary Beth Bachman Street, OTR/L

  • Occupational Therapist
  • Dayton, OH
National Provider Identifier
1407408446
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT010569 Issued in OH
Practice address
4801 Springfield St
Dayton, OH 45431-1084
Phone
(937) 236-9965
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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 OT010569 OH Primary

Addresses

Primary practice location

4801 Springfield St
Dayton, OH 45431-1084

Mailing address

4801 Springfield St
Dayton, OH 45431-1084
Phone (937) 236-9965

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210308002005 TN Practitioner - Occupational Therapist in Private Practice 4981010469 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT010569OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Feb 4, 2021 Accepting new patients
Ribbons Physical Therapy, LLC Occupational Therapist CurrentSince Mar 22, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Feb 4, 2021 Accepting new patients
Montgomery County Educational Service Center Past Accepting new patients

Locations

960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178

508 Princeton Rd
Ste 305
Johnson City, TN 37601
Phone (423) 251-4742

300 Clinchfield St
Ste 320
Kingsport, TN 37660
Phone (423) 251-4742

Organizations & group practices 4

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1407408446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 SPRINGFIELD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311084",
            "telephone_number": "937-236-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 SPRINGFIELD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311084",
            "telephone_number": "937-236-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "MARY",
        "middle_name": "BETH BACHMAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT010569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.