Individual provider Active NPI

Todd Metcalf, OTR/L

  • Pediatric Occupational Therapist
  • Portland, ME
National Provider Identifier
1609887660
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 1418 Issued in ME
Practice address
1321 Washington Ave
Dev. Services of Portland, Northport Professional BLDG
Portland, ME 04103-3636
Phone
(207) 712-5284
NPI assigned
Aug 11, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT 1418 ME Primary

Addresses

Primary practice location

1321 Washington Ave
Dev. Services of Portland, Northport Professional BLDG
Portland, ME 04103-3636

Mailing address

60 Vincent St
South Portland, ME 04106-3950
Phone (207) 712-5284

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
OT 1418MEMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609887660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 VINCENT ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063950",
            "telephone_number": "207-712-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "address_2": "DEV. SERVICES OF PORTLAND, NORTHPORT PROFESSIONAL BLDG",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033636",
            "telephone_number": "207-712-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "TODD",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ME",
            "license": "OT 1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.