Elizabeth Dakelman Balog, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

03037 Issued in MD

Practice address

11690 Neelsville Church Rd
Germantown, MD 20876-4127

Phone

(301) 353-0972

Fax

(301) 601-0381

NPI assigned

Nov 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: liz.balog.p3@direct.mcg-hhs.nextgenshare.com
• Direct secure messaging: liz.balog.p1@direct.mcg-hhs.nextgenshare.com

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1750859062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11690 NEELSVILLE CHURCH RD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764127",
            "telephone_number": "301-353-0972",
            "fax_number": "301-601-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11690 NEELSVILLE CHURCH RD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764127",
            "telephone_number": "301-353-0972",
            "fax_number": "301-601-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOG",
        "first_name": "ELIZABETH",
        "middle_name": "DAKELMAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "0062",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "03037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD STATE BOARD OF OCCUPATIONAL THERY PRACTITIONERS",
            "identifier": "03037",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rajesh Balchandani, D.D.S.
• Snigdha Balchandani, DMD
• Tugba Balci
• Varsha Balijepalli
• Brittni Larae Ballou, LGPC
• Aaron Josef Banas, PSYD
• Melissa Renee Hardimon Bandele, APRN
• Madan S Bangalore, M.D.
• Hayley Bannister
• Vishal M Bant

• Occupational Therapist in Germantown, MD
• Providers in Germantown, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.