Individual provider Active NPI

Emily Patricia Shrader

  • Occupational Therapy Assistant
  • Waterville, ME
National Provider Identifier
1760186068
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OA3389 Issued in ME
Practice address
27 Cool St
Waterville, ME 04901-5221
Phone
(207) 873-0721
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OA3389 ME Primary

Addresses

Primary practice location

27 Cool St
Waterville, ME 04901-5221

Mailing address

42 Martin Stream Rd
Fairfield, ME 04937-3010
Phone (207) 399-7208

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
OA3389MEMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1760186068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MARTIN STREAM RD",
            "city": "FAIRFIELD",
            "state": "ME",
            "postal_code": "049373010",
            "telephone_number": "207-399-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 COOL ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015221",
            "telephone_number": "207-873-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRADER",
        "first_name": "EMILY",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OA3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.