Individual provider Active NPI

Amanda Brown

  • Occupational Therapist
  • Coventry, RI
National Provider Identifier
1902359367
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT01696 Issued in RI
Practice address
4 Coventry Shoppers Park
Coventry, RI 02816-5702
Phone
(401) 368-4263
NPI assigned
Aug 2, 2016
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT01696 RI Primary
Community Health Worker 172V00000X OTA00602 RI
Community Health Worker 172V00000X OT01596 RI

Addresses

Primary practice location

4 Coventry Shoppers Park
Coventry, RI 02816-5702

Mailing address

4 Coventry Shoppers Park
Coventry, RI 02816-5702
Phone (401) 828-1781

Other practice location 1

1193 Reservoir Ave
Cranston, RI 02920-6008
Phone (401) 228-3939

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL RILYMPHEDEMATHERAPY@GMAIL.COM Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216001203 RI Practitioner - Occupational Therapist in Private Practice 2264801828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Lymphedema Therapy, LLCGroup PAC ID 0446629000, 2 clinicians

Practice addresses (Care Compare)

4 Coventry Shoppers Park
Coventry, RI 02816-5702
Phone (401) 368-4263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT01596RIMDCommunity Health Worker
OTA00602RIMDCommunity Health Worker
OT01696RIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Lymphedema Therapy, LLC CurrentSince Sep 21, 2022 Accepting new patients
Gaffney Physical Therapy, LLC Occupational Therapist Past Accepting new patients

Locations

4 Coventry Shoppers Park
Coventry, RI 02816
Phone (401) 368-4263

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, 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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1902359367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COVENTRY SHOPPERS PARK",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165702",
            "telephone_number": "401-828-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COVENTRY SHOPPERS PARK",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165702",
            "telephone_number": "401-368-4263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1193 Reservoir Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029206008",
            "country_code": "US",
            "telephone_number": "401-228-3939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "RI",
            "license": "OT01696",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "RI",
            "license": "OTA00602",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "RI",
            "license": "OT01596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "RILYMPHEDEMATHERAPY@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "BUSINESS EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Coventry Shoppers Park",
            "city": "Coventry",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028165702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.