Individual provider Active NPI

Krystal Monique Brewington, MS, OTR/L, CPAM

  • Hand Occupational Therapist
  • Clinton, MD
National Provider Identifier
1770901258
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
06863 Issued in MD
Practice address
7905 Malcolm Rd
Ste 201
Clinton, MD 20735-1749
Phone
(301) 856-0050
Fax
(301) 856-0518
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 06863 MD Primary

Addresses

Primary practice location

7905 Malcolm Rd
Ste 201
Clinton, MD 20735-1749

Mailing address

10 Saint Patricks Dr
Ste 401
Waldorf, MD 20603-4583
Phone (301) 870-9783

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
06863MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1770901258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAINT PATRICKS DR",
            "address_2": "STE 401",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034583",
            "telephone_number": "301-870-9783",
            "fax_number": "301-870-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 MALCOLM RD",
            "address_2": "STE 201",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351749",
            "telephone_number": "301-856-0050",
            "fax_number": "301-856-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWINGTON",
        "first_name": "KRYSTAL",
        "middle_name": "MONIQUE",
        "credential": "MS, OTR/L, CPAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MD",
            "license": "06863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.