Brian Witherell, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OA4088 Issued in ME

Practice address

15 Strawberry Ave
Lewiston, ME 04240-5941

Phone

(207) 777-7740

NPI assigned

May 12, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1922535624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ELM ST",
            "city": "JAY",
            "state": "ME",
            "postal_code": "042391735",
            "telephone_number": "681-209-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STRAWBERRY AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405941",
            "telephone_number": "207-777-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERELL",
        "first_name": "BRIAN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP008369",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WV",
            "license": "C2059",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OA4088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Occupational Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.