Active NPI
Samuel Eli Brookover, MOTR/L
- Occupational Therapist
- Bridgeport, WV
National Provider Identifier
1740826064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2080
- Practice address
- 1000 Maplewood Dr
Bridgeport, WV 26330-9115 - Phone
- (304) 848-0200
- NPI assigned
- Nov 21, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 2080 | WV | Primary |
Addresses
Primary practice location
1000 Maplewood Dr
Bridgeport, WV 26330-9115
Mailing address
2991 Doolin Run Rd
New Martinsville, WV 26155-7830
Phone (304) 455-5901
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1740826064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2991 DOOLIN RUN RD",
"city": "NEW MARTINSVILLE",
"state": "WV",
"postal_code": "261557830",
"telephone_number": "304-455-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MAPLEWOOD DR",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309115",
"telephone_number": "304-848-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKOVER",
"first_name": "SAMUEL",
"middle_name": "ELI",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-21",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WV",
"license": "2080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WV
- Bridgeport Prescription Shop LLC (Community Pharmacy of Bridgeport)
- Bridgeport Senior Living, LLC (The Heritage Senior Living Community)
- Bridgeport Senior Living, LLC (The Heritage)
- Bridgeport SNF LLC (Bridgeport Rehabilitation & Healthcare Center)
- Geannine Britanak-Gulas, LPN
- Jamie L Brown, PRSS
- Kendra Marie Brown, RN
- Savanna Tamia Brown, MSW
- Jeffrey Wayne Browning, DDS
- BRX LLC (Champion Pharmacy and Wellness)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.