Active NPI
Brandy Rose Liljeblad
- Occupational Therapist
- Groton, MA
National Provider Identifier
1669055331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13984
- Practice address
- 8 Lilac Circle
Unit B
Groton, MA 01450 - Phone
- (617) 461-4923
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13984 | NC | Primary |
Addresses
Primary practice location
8 Lilac Circle
Unit B
Groton, MA 01450
Mailing address
8 Lilac Circle
Unit B
Groton, MA 01450
Phone (617) 461-4923
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13984 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619740800000",
"number": "1669055331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 LILAC CIRCLE",
"address_2": "UNIT B",
"city": "GROTON",
"state": "MA",
"postal_code": "01450",
"telephone_number": "617-461-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 LILAC CIRCLE",
"address_2": "UNIT B",
"city": "GROTON",
"state": "MA",
"postal_code": "01450",
"telephone_number": "617-461-4923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILJEBLAD",
"first_name": "BRANDY",
"middle_name": "ROSE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-30",
"last_updated": "2021-04-30",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "13984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.