Active NPI
Melissa Eagen
- Occupational Therapist
- Baltimore, MD
National Provider Identifier
1770717118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00004515
- Practice address
- 707 N. Broadway
Baltimore, MD 21205 - Phone
- (443) 923-9200
- Fax
- (425) 656-5075
- NPI assigned
- May 13, 2009
- Last updated
- Sep 7, 2022
- Sex
- Female
- 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 | OT00004515 | WA | Primary |
Addresses
Primary practice location
707 N. Broadway
Baltimore, MD 21205
Mailing address
1741 Ashland Ave
Baltimore, MD 21205
Phone (425) 656-4215
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT00004515 | WA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital District #1 of King County | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba VMC Children's Therapy
- Rehabilitation Hospital Unit
- Renton, WA
- NPI 1811063308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1770717118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1741 ASHLAND AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21205",
"telephone_number": "425-656-4215",
"fax_number": "425-656-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 N. BROADWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21205",
"telephone_number": "443-923-9200",
"fax_number": "425-656-5075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGEN",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-13",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT00004515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.