Individual provider Active NPI

Samantha Hafford, COTA/L

  • Occupational Therapy Assistant
  • Bangor, ME
National Provider Identifier
1548532963
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OA2556 Issued in ME
Practice address
1434 Ohio St
Unit #5
Bangor, ME 04401-2774
Phone
(207) 385-3260
NPI assigned
Jan 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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 OA2556 ME Primary

Addresses

Primary practice location

1434 Ohio St
Unit #5
Bangor, ME 04401-2774

Mailing address

1434 Ohio St
Unit #5
Bangor, ME 04401-2774
Phone (207) 385-3260

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
OA2556MEMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1548532963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 OHIO ST",
            "address_2": "UNIT #5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012774",
            "telephone_number": "207-385-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 OHIO ST",
            "address_2": "UNIT #5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012774",
            "telephone_number": "207-385-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFFORD",
        "first_name": "SAMANTHA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OA2556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.