Individual provider Active NPI

Ervin David Arredondo, OTR

  • Occupational Therapist
  • Holmdel, NJ
National Provider Identifier
1821167784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00373800 Issued in NJ
Practice address
56 Bethany Rd
Holmdel, NJ 07733-1444
Phone
(732) 203-2188
Fax
(732) 203-2188
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00373800 NJ Primary

Addresses

Primary practice location

56 Bethany Rd
Holmdel, NJ 07733-1444

Mailing address

56 Bethany Rd
Holmdel, NJ 07733-1444
Phone (732) 203-2188

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

State licenses

LicenseStateTypeSpecialty
013233NYMDDental Hygienist
46TR00373800NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821167784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 BETHANY RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331444",
            "telephone_number": "732-203-2188",
            "fax_number": "732-203-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 BETHANY RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331444",
            "telephone_number": "732-203-2188",
            "fax_number": "732-203-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "ERVIN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00373800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.