Individual provider Active NPI

Jaimie Dube

  • Occupational Therapist
  • Windham, ME
National Provider Identifier
1720603814
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3852 Issued in ME
Practice address
10 Trails End Rd
Windham, ME 04062-7307
Phone
(207) 233-7373
NPI assigned
Jun 15, 2020
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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 OT3852 ME Primary

Addresses

Primary practice location

10 Trails End Rd
Windham, ME 04062-7307

Mailing address

58 Ferry Rd
Saco, ME 04072-2111
Phone (207) 229-3110

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

LicenseStateTypeSpecialty
OT3852MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maine Pediatric Therapies, PLLC Occupational Therapist PastSince Jun 21, 2020 Accepting new patients
Pediatric Development Center Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1720603814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 FERRY RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040722111",
            "telephone_number": "207-229-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRAILS END RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040627307",
            "telephone_number": "207-233-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "JAIMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT3852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.