Active NPI
Adrienne Bogardus, OTR
- Occupational Therapist
- Portland, ME
National Provider Identifier
1790938470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT2520
- Practice address
- 1011 Forest Ave
Portland, ME 04103-3304 - Phone
- (207) 615-4596
- NPI assigned
- Oct 28, 2008
- Last updated
- Aug 25, 2023
- 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 | OT2520 | ME | Primary |
Addresses
Primary practice location
1011 Forest Ave
Portland, ME 04103-3304
Mailing address
11 Clipper St
Cumberland Foreside, ME 04110-1354
Phone (207) 615-4596
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 |
|---|---|---|---|
| OT2520 | ME | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1790938470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CLIPPER ST",
"city": "CUMBERLAND FORESIDE",
"state": "ME",
"postal_code": "041101354",
"telephone_number": "207-615-4596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 FOREST AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041033304",
"telephone_number": "207-615-4596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGARDUS",
"first_name": "ADRIENNE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2023-08-25",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT2520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.