Brandywine Occupational Therapy, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

U1-0001108 Issued in DE

Legal business name

BRANDYWINE OCCUPATIONAL THERAPY, LLC

Practice address

800 Carr Road
Wilmington, DE 19809

Phone

(302) 740-4798

Fax

(302) 761-6951

NPI assigned

Aug 24, 2010

Last updated

Jul 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Janusz

Title

Owner

Phone

(302) 740-4798

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1578879888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CARR ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19809",
            "telephone_number": "302-740-4798",
            "fax_number": "302-761-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CARR ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19809",
            "telephone_number": "302-740-4798",
            "fax_number": "302-761-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE OCCUPATIONAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "JANUSZ",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-740-4798"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "DE",
            "license": "U1-0001108",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "DE",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.

Verify at the official NPI Registry.