David Backholm, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

4618 Issued in ME

Practice address

29 Westminster St
Lewiston, ME 04240-3531

Phone

(207) 777-7001

NPI assigned

Apr 29, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright Start Therapy, Inc.

  • Speech-Language Pathologist
  • Lewiston, ME
  • NPI 1114363686

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1831945898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WEBSTER ST APT 3",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042408524",
            "telephone_number": "774-276-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 WESTMINSTER ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403531",
            "telephone_number": "207-777-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKHOLM",
        "first_name": "DAVID",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ME",
            "license": "4618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Ayala, DMD
• Ayda Home Care LLC
• B&H Support Services LLC
• Alexander Babaoghli, DO
• Megan Jude Bachelder, OTR/L
• Jeffrey Badillo, MD
• Britney Bagley, PTA
• Tonya Dee Bailey-Curry, LCSW
• Audra S Bailey, SLP
• Cynthia K Bailey

• All providers in Lewiston, ME
• Pediatric Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.