Jessica Baumgold, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

9845007 Issued in NY

Practice address

36 Union St
Dryden, NY 13053

Phone

(607) 844-8694

NPI assigned

Feb 11, 2019

Last updated

Feb 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Shurberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1609331032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WARREN RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 UNION ST",
            "city": "DRYDEN",
            "state": "NY",
            "postal_code": "13053",
            "telephone_number": "607-844-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGOLD",
        "first_name": "JESSICA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "9845007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SHURBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Akselrod, PT
• Leslie Ruth Allerton-Moffitt, M.S., CCC-SLP/A
• Edith A Ayer, MA/CCC-SLP
• Arlene Frances Bahar
• Mary Balfour, M.S., CCC-SLP
• Kate Benas, LMSW
• Travis Eugene Berggren
• Lynn Suzanne Boettger, SPEECH/LANGUAGE PATH
• Jeffrey Linn Bookhout, RPH
• Nicole Brinn

• Occupational Therapist in Dryden, NY
• Providers in Dryden, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.