Individual provider Active NPI

Erin Kathryn Bertram, M.A.

  • Occupational Therapist
  • Phoenix, AZ
National Provider Identifier
1851714174
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5673 Issued in AZ
Practice address
3348 W McDowell Rd
Phoenix, AZ 85009-2416
Phone
(602) 455-6700
Fax
(602) 278-1693
NPI assigned
Jan 22, 2014
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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 5673 AZ Primary

Addresses

Primary practice location

3348 W McDowell Rd
Phoenix, AZ 85009-2416

Mailing address

2801 N Litchfield Rd Unit 20
Goodyear, AZ 85395-2004
Phone (623) 210-6425

Other identifiers 1

IdentifierTypeStateIssuer
5673OtherAZARIZONA STATE BOARD OF OCCUPATIONAL THERAPY EXAMINERS

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5673AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Isaac School District No. 5 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1851714174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N LITCHFIELD RD UNIT 20",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952004",
            "telephone_number": "623-210-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 W MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850092416",
            "telephone_number": "602-455-6700",
            "fax_number": "602-278-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "ERIN",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "5673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF OCCUPATIONAL THERAPY EXAMINERS",
            "identifier": "5673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.