Individual provider Active NPI

Nicole Suzanne Bilodeau, OT

  • Pediatric Occupational Therapist
  • Portland, OR
National Provider Identifier
1427874726
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
986531 Issued in OR
Practice address
7100 SE Division St
Portland, OR 97206-1143
Phone
(503) 916-3426
NPI assigned
Dec 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 986531 OR Primary

Addresses

Primary practice location

7100 SE Division St
Portland, OR 97206-1143

Mailing address

12899 SW 113TH PL
Tigard, OR 97223-3974
Phone (503) 680-6429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
986531ORMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1427874726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12899 SW 113TH PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233974",
            "telephone_number": "503-680-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061143",
            "telephone_number": "503-916-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILODEAU",
        "first_name": "NICOLE",
        "middle_name": "SUZANNE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "986531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.