Individual provider Active NPI

Maura Sherry Hallstead, ORT/L

  • Occupational Therapist
  • Canandaigua, NY
National Provider Identifier
1619275633
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005190 Issued in NY
Practice address
5415 County Road 30
Canandaigua, NY 14424-7964
Phone
(585) 394-9510
NPI assigned
Mar 1, 2011
Last updated
Mar 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005190 NY Primary

Addresses

Primary practice location

5415 County Road 30
Canandaigua, NY 14424-7964

Mailing address

5415 County Road 30
Canandaigua, NY 14424-7964
Phone (585) 394-9510

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
005190NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1619275633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 COUNTY ROAD 30",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 COUNTY ROAD 30",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLSTEAD",
        "first_name": "MAURA",
        "middle_name": "SHERRY",
        "name_prefix": "Ms.",
        "credential": "ORT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "005190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.