Active NPI
Brooklynn Mae Northern, OTD
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1831978717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 289403
- Practice address
- 982 Eastern Pkwy
Louisville, KY 40217-1566 - Phone
- (502) 635-6397
- NPI assigned
- Sep 28, 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 | 289403 | KY | Primary |
Addresses
Primary practice location
982 Eastern Pkwy
Louisville, KY 40217-1566
Mailing address
304 Jackson Way
Charlestown, IN 47111-0030
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 |
|---|---|---|---|
| 289403 | KY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cerebral Palsy Kids Center Inc | Occupational Therapist | 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 and National Provider Directory roles.
-
- Health Service Clinic/Center
- Louisville, KY
- NPI 1851450464
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1831978717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 JACKSON WAY",
"city": "CHARLESTOWN",
"state": "IN",
"postal_code": "471110030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "982 EASTERN PKWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171566",
"telephone_number": "502-635-6397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHERN",
"first_name": "BROOKLYNN",
"middle_name": "MAE",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-28",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "289403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.