NPIMap

Individual provider Active NPI

Carolyn Eisner

  • Occupational Therapist
  • South Portland, ME
National Provider Identifier
1891009684
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT30 Issued in ME
Practice address
130 Wescott Rd
South Portland School Department
South Portland, ME 04106-3420
Phone
(207) 871-0555
Fax
(207) 871-0559
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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 OT30 ME Primary

Addresses

Primary practice location

130 Wescott Rd
South Portland School Department
South Portland, ME 04106-3420

Mailing address

130 Wescott Rd
South Portland School Department
South Portland, ME 04106-3420
Phone (207) 871-0555

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

LicenseStateTypeSpecialty
OT30MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City of South Portland Past Accepting new patients
City of South Portland Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1891009684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WESCOTT RD",
            "address_2": "SOUTH PORTLAND SCHOOL DEPARTMENT",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063420",
            "telephone_number": "207-871-0555",
            "fax_number": "207-871-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WESCOTT RD",
            "address_2": "SOUTH PORTLAND SCHOOL DEPARTMENT",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063420",
            "telephone_number": "207-871-0555",
            "fax_number": "207-871-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISNER",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.