Individual provider Active NPI

Bryan John Wodaski, MS OTRL CHT

  • Occupational Therapist
  • Cumberland, MD
National Provider Identifier
1689682643
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
03241 Issued in MD
Practice address
200 Glenn Street
Ste 200
Cumberland, MD 21502
Phone
(301) 759-4263
Fax
(301) 759-4461
NPI assigned
Aug 4, 2006
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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 03241 MD Primary

Addresses

Primary practice location

200 Glenn Street
Ste 200
Cumberland, MD 21502

Mailing address

PO Box 1517
Cumberland, MD 21501-1517
Phone (301) 759-6317

Other identifiers 1

IdentifierTypeStateIssuer
0159766000MedicaidWV

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
03241MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therafit Enterprises, Inc. PastSince May 29, 2017 Accepting new patients
Virginia Home Therapy LLC PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1689682643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011517",
            "telephone_number": "301-759-6317",
            "fax_number": "301-759-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GLENN STREET",
            "address_2": "STE 200",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-759-4263",
            "fax_number": "301-759-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODASKI",
        "first_name": "BRYAN",
        "middle_name": "JOHN",
        "credential": "MS OTRL CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "03241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159766000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.