Individual provider Active NPI

Aubrey R Neidermyer

  • Occupational Therapist
  • Greenwood, SC
National Provider Identifier
1922404755
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2110 Issued in SC
Practice address
228 N Creek Blvd
Greenwood, SC 29649-9006
Phone
(410) 889-0727
Fax
(410) 889-0729
NPI assigned
Nov 5, 2014
Last updated
Nov 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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 2110 SC Primary

Addresses

Primary practice location

228 N Creek Blvd
Greenwood, SC 29649-9006

Mailing address

416 E 30TH St
Baltimore, MD 21218-3934
Phone (410) 889-0727

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2110SCMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1922404755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E 30TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183934",
            "telephone_number": "410-889-0727",
            "fax_number": "410-889-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 N CREEK BLVD",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296499006",
            "telephone_number": "410-889-0727",
            "fax_number": "410-889-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDERMYER",
        "first_name": "AUBREY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.