Individual provider Active NPI

Janaye Mack

  • Occupational Therapy Assistant
  • Glen Burnie, MD
National Provider Identifier
1508245754
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
A02115 Issued in MD
Practice address
309 Maple Tree Dr Apt 2G
Glen Burnie, MD 21060-8564
Phone
(667) 231-1033
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A02115 MD Primary

Addresses

Primary practice location

309 Maple Tree Dr Apt 2G
Glen Burnie, MD 21060-8564

Mailing address

309 Maple Tree Dr Apt 2G
Glen Burnie, MD 21060-8564
Phone (667) 231-1033

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
A02115MDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1508245754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MAPLE TREE DR APT 2G",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608564",
            "telephone_number": "667-231-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MAPLE TREE DR APT 2G",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608564",
            "telephone_number": "667-231-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JANAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.