Individual provider Active NPI

Cindy L Cusumano Maynard, OTR/L

  • Pediatric Occupational Therapist
  • Salem, OR
National Provider Identifier
1750531307
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1000512 Issued in OR
Practice address
290 Moyer LN NW
Salem, OR 97304-3822
Phone
(503) 370-8990
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1000512 OR Primary

Addresses

Primary practice location

290 Moyer LN NW
Salem, OR 97304-3822

Mailing address

4950 Albion CT SE
Salem, OR 97302-1896
Phone (503) 914-7671

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
1000512ORMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Oregon Children's Therapy Center Past Accepting new patients
Easter Seals Oregon 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": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1750531307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 ALBION CT SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021896",
            "telephone_number": "503-914-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MOYER LN NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043822",
            "telephone_number": "503-370-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO MAYNARD",
        "first_name": "CINDY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "1000512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.