Active NPI
Mary Anne Gammon, OTR
- Occupational Therapist
- Sacramentno, CA
National Provider Identifier
1912254129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1669
- Practice address
- 6301 Surfside Way
Sacramentno, CA 95831-1027 - Phone
- (530) 220-2711
- Fax
- (916) 706-2074
- NPI assigned
- Aug 7, 2012
- Last updated
- Aug 7, 2012
- Sex
- Female
- 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 Therapist | 225X00000X | 1669 | CA | Primary |
Addresses
Primary practice location
6301 Surfside Way
Sacramentno, CA 95831-1027
Mailing address
6301 Surfside Way
Sacramentno, CA 95831-1027
Phone (530) 220-2711
Other names 1
- Marianne Gammon
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 |
|---|---|---|---|
| 1669 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344297600000",
"number": "1912254129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 SURFSIDE WAY",
"city": "SACRAMENTNO",
"state": "CA",
"postal_code": "958311027",
"telephone_number": "530-220-2711",
"fax_number": "916-706-2074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 SURFSIDE WAY",
"city": "SACRAMENTNO",
"state": "CA",
"postal_code": "958311027",
"telephone_number": "530-220-2711",
"fax_number": "916-706-2074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMMON",
"first_name": "MARY",
"middle_name": "ANNE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-07",
"last_updated": "2012-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "1669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIANNE",
"last_name": "GAMMON",
"code": "2",
"type": "Professional Name"
}
]
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.