Active NPI
Andrea Medeiros
- Occupational Therapy Assistant
- Peabody, MA
National Provider Identifier
1922514157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4194
- Practice address
- 96 Forest St
Peabody, MA 01960-3907 - Phone
- (978) 532-0303
- NPI assigned
- Dec 26, 2017
- 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 Therapy Assistant | 224Z00000X | 4194 | MA | Primary |
Addresses
Primary practice location
96 Forest St
Peabody, MA 01960-3907
Mailing address
206 Metacom Ave
Warren, RI 02885-1926
Phone (401) 245-8201
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 |
|---|---|---|---|
| 4194 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1922514157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 METACOM AVE",
"city": "WARREN",
"state": "RI",
"postal_code": "028851926",
"telephone_number": "401-245-8201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 FOREST ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603907",
"telephone_number": "978-532-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "ANDREA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-26",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "4194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.