Mark Edgar Guillemette, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2991 Issued in MA

Practice address

626 Eastview Ave
Somerset, MA 02726-3809

Phone

(508) 335-2495

NPI assigned

Feb 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1528307634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 EASTVIEW AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027263809",
            "telephone_number": "508-335-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 EASTVIEW AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027263809",
            "telephone_number": "508-335-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEMETTE",
        "first_name": "MARK",
        "middle_name": "EDGAR",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-08",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "2991",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "RI",
            "license": "OTA00366",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Somerset, MA
• Providers in Somerset, MA by specialty
• Occupational Therapy Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.