Active NPI
Andrea Lea Gahan, OTR,L
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1487776225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1539
- Practice address
- 6400 Uptown Blvd NE
Albuquerque, NM 87110-4204 - Phone
- (505) 880-3700
- NPI assigned
- Apr 4, 2007
- 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 | 1539 | NM | Primary |
Addresses
Primary practice location
6400 Uptown Blvd NE
Albuquerque, NM 87110-4204
Mailing address
7404 Sulky Dr NE
Albuquerque, NM 87109-6804
Phone (505) 797-1270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000B9176 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1539 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487776225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7404 SULKY DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871096804",
"telephone_number": "505-797-1270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 UPTOWN BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104204",
"telephone_number": "505-880-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAHAN",
"first_name": "ANDREA",
"middle_name": "LEA",
"name_prefix": "Mrs.",
"credential": "OTR,L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "1539",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000B9176",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.