Cody J Halvorson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4562 Issued in ME

Practice address

103 Boulder Point Dr
Plymouth, NH 03264-3168

Phone

(603) 536-1881

Fax

(603) 238-2198

NPI assigned

Feb 8, 2024

Last updated

Feb 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1417711508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 LADNER RD",
            "city": "EASTON",
            "state": "ME",
            "postal_code": "047404316",
            "telephone_number": "207-227-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BOULDER POINT DR",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643168",
            "telephone_number": "603-536-1881",
            "fax_number": "603-238-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "CODY",
        "middle_name": "J",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Plymouth, NH
• Providers in Plymouth, NH by specialty
• Occupational Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.