Active NPI
John Paulo Tan
- Occupational Therapist
- Annapolis, MD
National Provider Identifier
1679986178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 07060
- Practice address
- 830 Monroe St Apt 107
Annapolis, MD 21403-1715 - Phone
- (202) 316-7814
- NPI assigned
- Jun 3, 2014
- Sex
- Male
- 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 | 07060 | MD | Primary |
Addresses
Primary practice location
830 Monroe St Apt 107
Annapolis, MD 21403-1715
Mailing address
830 Monroe St Apt 107
Annapolis, MD 21403-1715
Phone (202) 316-7814
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07060 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401753600000",
"number": "1679986178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 MONROE ST APT 107",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214031715",
"telephone_number": "202-316-7814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 MONROE ST APT 107",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214031715",
"telephone_number": "202-316-7814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "JOHN PAULO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-03",
"last_updated": "2014-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "07060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.