Active NPI
Carlyn Eisenhauer Burdick, M.S, OTR/L
- Occupational Therapist
- Peabody, MA
National Provider Identifier
1851835649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11225
- Practice address
- 1R Newbury St
Peabody, MA 01960-4065 - Phone
- (978) 535-3355
- NPI assigned
- Dec 13, 2016
- 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 | 11225 | MA | Primary |
Addresses
Primary practice location
1R Newbury St
Peabody, MA 01960-4065
Mailing address
1R Newbury St
Peabody, MA 01960-4065
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11225 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1851835649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1R NEWBURY ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019604065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1R NEWBURY ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019604065",
"telephone_number": "978-535-3355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDICK",
"first_name": "CARLYN",
"middle_name": "EISENHAUER",
"name_prefix": "Ms.",
"credential": "M.S, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-13",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "11225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.