Active NPI
Brandon McIntyre
- Occupational Therapy Assistant
- Daniels, WV
National Provider Identifier
1881055374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- C2028
- Practice address
- 1631 Ritter Dr
Daniels, WV 25832-9264 - Phone
- (304) 763-3051
- NPI assigned
- Mar 11, 2016
- Last updated
- Mar 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | C2028 | WV | Primary |
Addresses
Primary practice location
1631 Ritter Dr
Daniels, WV 25832-9264
Mailing address
1631 Ritter Dr
Daniels, WV 25832-9264
Phone (304) 763-3051
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 |
|---|---|---|---|
| C2028 | WV | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457654400000",
"number": "1881055374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 RITTER DR",
"city": "DANIELS",
"state": "WV",
"postal_code": "258329264",
"telephone_number": "304-763-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 RITTER DR",
"city": "DANIELS",
"state": "WV",
"postal_code": "258329264",
"telephone_number": "304-763-3051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-11",
"last_updated": "2016-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WV",
"license": "C2028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daniels, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.