Active NPI
Lauralee Fitzgerald Gordon, OTR
- Occupational Therapist
- Severna Park, MD
National Provider Identifier
1568051118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 09179
- Practice address
- 645 Baltimore Annapolis Blvd
Severna Park, MD 21146-3931 - Phone
- (410) 544-2500
- NPI assigned
- Jan 18, 2021
- 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 | 09179 | MD | Primary |
Addresses
Primary practice location
645 Baltimore Annapolis Blvd
Severna Park, MD 21146-3931
Mailing address
700 Americana Dr Apt 38
Annapolis, MD 21403-3178
Phone (410) 200-3518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09179 | MD | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Winchester, VA
- NPI 1609814755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610928000000",
"number": "1568051118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 AMERICANA DR APT 38",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214033178",
"telephone_number": "410-200-3518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 BALTIMORE ANNAPOLIS BLVD",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211463931",
"telephone_number": "410-544-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LAURALEE",
"middle_name": "FITZGERALD",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-18",
"last_updated": "2021-01-18",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "09179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.