Active NPI
Karen Sue Jordan, OTR/L, C/LT, C/NDT
- Physical Rehabilitation Occupational Therapist
- Gambrills, MD
National Provider Identifier
1477887909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 1374
- Practice address
- 1004 Autumn Gold Dr
Gambrills, MD 21054-1500 - Phone
- (443) 306-8892
- NPI assigned
- Oct 1, 2009
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 1374 | MD | Primary |
Addresses
Primary practice location
1004 Autumn Gold Dr
Gambrills, MD 21054-1500
Mailing address
1004 Autumn Gold Dr
Gambrills, MD 21054-1500
Phone (443) 306-8892
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1374 | MD | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1477887909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 AUTUMN GOLD DR",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "210541500",
"telephone_number": "443-306-8892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 AUTUMN GOLD DR",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "210541500",
"telephone_number": "443-306-8892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "KAREN",
"middle_name": "SUE",
"credential": "OTR/L, C/LT, C/NDT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "MD",
"license": "1374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gambrills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.