Active NPI
Carol Raeburn-Allen, OTR
- Occupational Therapist
- Baltimore, MD
National Provider Identifier
1548474935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 04760
- Practice address
- 115 E Melrose
Baltimore, MD 21212 - Phone
- (410) 435-9073
- Fax
- (410) 435-0761
- NPI assigned
- May 9, 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 | 04760 | MD | Primary |
Addresses
Primary practice location
115 E Melrose
Baltimore, MD 21212
Mailing address
4515 Dresden Road
Pikesville
Baltimore, MD 21208
Phone (410) 655-0345
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 |
|---|---|---|---|
| 04760 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548474935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4515 DRESDEN ROAD",
"address_2": "PIKESVILLE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21208",
"telephone_number": "410-655-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E MELROSE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21212",
"telephone_number": "410-435-9073",
"fax_number": "410-435-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAEBURN-ALLEN",
"first_name": "CAROL",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "04760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
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.