Active NPI
Garrett Dellwood Davidson, COTA
- Occupational Therapy Assistant
- Cumberland, MD
National Provider Identifier
1578697488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- A01499
- Practice address
- 10301 Christie Rd NE
Cumberland, MD 21502-8326 - Phone
- (301) 724-1400
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | A01499 | MD | Primary |
Addresses
Primary practice location
10301 Christie Rd NE
Cumberland, MD 21502-8326
Mailing address
1721 Bedford St
Cumberland, MD 21502-1011
Phone (301) 777-8071
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 |
|---|---|---|---|
| A01499 | MD | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578697488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 BEDFORD ST",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215021011",
"telephone_number": "301-777-8071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10301 CHRISTIE RD NE",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215028326",
"telephone_number": "301-724-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "GARRETT",
"middle_name": "DELLWOOD",
"name_prefix": "Mr.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "A01499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumberland, 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.