Individual provider Active NPI

Josephine C Palmer, COTA/L BBA

  • Occupational Therapy Assistant
  • Columbia, MD
National Provider Identifier
1699015198
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
P-456-440-112-640 Issued in MD
Practice address
10596 Twin Rivers Rd Apt B1
Columbia, MD 21044-2113
Phone
(240) 354-9711
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X P-456-440-112-640 MD Primary

Addresses

Primary practice location

10596 Twin Rivers Rd Apt B1
Columbia, MD 21044-2113

Mailing address

10596 Twin Rivers Rd Apt B1
Columbia, MD 21044-2113
Phone (240) 354-9711

Other identifiers 1

IdentifierTypeStateIssuer
P-456-440-112-640OtherMDSTATE LICENSE

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
Credentials
Bachelor of Business Administration

State licenses

LicenseStateTypeSpecialty
P-456-440-112-640MDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1699015198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10596 TWIN RIVERS RD APT B1",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442113",
            "telephone_number": "240-354-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10596 TWIN RIVERS RD APT B1",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442113",
            "telephone_number": "240-354-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JOSEPHINE",
        "middle_name": "C",
        "credential": "COTA/L BBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "P-456-440-112-640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "P-456-440-112-640",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.