Individual provider Active NPI

Carrie Pollard Donoghue, MS, OTR/L

  • Occupational Therapist
  • Freeport, ME
National Provider Identifier
1467769885
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT98 Issued in ME
Practice address
17 West St
Freeport, ME 04032-1121
Phone
(207) 865-2856
Fax
(207) 865-2855
NPI assigned
Sep 7, 2010
Last updated
Sep 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 OT98 ME Primary

Addresses

Primary practice location

17 West St
Freeport, ME 04032-1121

Mailing address

17 West St
Freeport, ME 04032-1121
Phone (207) 865-2856

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610001614 ME Practitioner - Occupational Therapist in Private Practice 2961735709 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT98MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
OT and Yoga LLC Occupational Therapist CurrentSince Apr 19, 2019 Accepting new patients
Regional School Unit No 5 Past Accepting new patients

Locations

15 Main St
Ste 15
Freeport, ME 04032

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1467769885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WEST ST",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040321121",
            "telephone_number": "207-865-2856",
            "fax_number": "207-865-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WEST ST",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040321121",
            "telephone_number": "207-865-2856",
            "fax_number": "207-865-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "CARRIE",
        "middle_name": "POLLARD",
        "name_prefix": "Ms.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.