Active NPI
Emily N Cornish
- Occupational Therapist
- Lewiston, ME
National Provider Identifier
1477397016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT4613
- Practice address
- 15 Strawberry Ave
Lewiston, ME 04240-5941 - Phone
- (207) 599-1909
- NPI assigned
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT4613 | ME | Primary |
Addresses
Primary practice location
15 Strawberry Ave
Lewiston, ME 04240-5941
Mailing address
15 Strawberry Ave
Lewiston, ME 04240-5941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240709002339 | ME | Practitioner - Physical Therapist in Private Practice | 3971048489 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1477397016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 STRAWBERRY AVE",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042405941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 STRAWBERRY AVE",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042405941",
"telephone_number": "207-599-1909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNISH",
"first_name": "EMILY",
"middle_name": "N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-19",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT4613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.