Pine State Low Vision Services LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PINE STATE LOW VISION SERVICES LLC

Practice address

19 Old Colony LN
Cumberland Center, ME 04021-3053

Phone

(207) 329-2497

Fax

(207) 286-3218

NPI assigned

Apr 25, 2007

Last updated

Apr 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherry A Mackinnon, OTR L

Title

Owner and Provider

Phone

(207) 329-2497

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1750500013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 OLD COLONY LN",
            "city": "CUMBERLAND CENTER",
            "state": "ME",
            "postal_code": "040213053",
            "telephone_number": "207-329-2497",
            "fax_number": "207-286-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD COLONY LN",
            "city": "CUMBERLAND CENTER",
            "state": "ME",
            "postal_code": "040213053",
            "telephone_number": "207-329-2497",
            "fax_number": "207-286-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE STATE LOW VISION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "MACKINNON",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER AND PROVIDER",
        "authorized_official_telephone_number": "207-329-2497",
        "authorized_official_credential": "OTR L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Cumberland Center, ME
• Providers in Cumberland Center, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.