Individual provider Active NPI

Keith Robert Partridge, COTA

  • Occupational Therapy Assistant
  • Worcester, MA
National Provider Identifier
1588879522
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2506 Issued in MA
Practice address
39 Butler St
Apt # 2
Worcester, MA 01607-1351
Phone
(508) 259-6594
NPI assigned
May 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2506 MA Primary

Addresses

Primary practice location

39 Butler St
Apt # 2
Worcester, MA 01607-1351

Mailing address

39 Butler St
Apt # 2
Worcester, MA 01607-1351
Phone (508) 259-6594

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
2506MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588879522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BUTLER ST",
            "address_2": "APT # 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071351",
            "telephone_number": "508-259-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BUTLER ST",
            "address_2": "APT # 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071351",
            "telephone_number": "508-259-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARTRIDGE",
        "first_name": "KEITH",
        "middle_name": "ROBERT",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

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.

Verify at the official NPI Registry.