Individual provider Active NPI

Magdalen Anne Gillard, OT-L

  • Occupational Therapist
  • Ithaca, NY
National Provider Identifier
1740564582
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0012941 Issued in NY
Practice address
3226 Wilkins Rd
Ithaca, NY 14850-9568
Phone
(607) 882-9520
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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 0012941 NY Primary

Addresses

Primary practice location

3226 Wilkins Rd
Ithaca, NY 14850-9568

Mailing address

110 Woolf LN
Ithaca, NY 14850-9551
Phone (607) 339-8625

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

LicenseStateTypeSpecialty
0012941NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1740564582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WOOLF LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509551",
            "telephone_number": "607-339-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 WILKINS RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509568",
            "telephone_number": "607-882-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "MAGDALEN",
        "middle_name": "ANNE",
        "credential": "OT-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0012941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.