Individual provider Active NPI

Elizabeth Gosnell

  • Occupational Therapist
  • Severna Park, MD
National Provider Identifier
1942690797
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07596 Issued in MD
Practice address
645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931
Phone
(410) 544-2500
Fax
(410) 384-9703
NPI assigned
Feb 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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 07596 MD Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931

Mailing address

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931
Phone (410) 544-2500

Other names 1

  • Elizabeth Tucker Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150508001677 MD Practitioner - Occupational Therapist in Private Practice 8527387745 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Maryland Central Payroll Bureau CurrentSince Jan 1, 2020 Accepting new patients
Cypress Creek Therapy Associates LLC Occupational Therapist CurrentSince Apr 15, 2015 Accepting new patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Jan 1, 2020 Accepting new patients

Locations

20 Mayo Rd
Ste 205
Edgewater, MD 21037
Phone (410) 384-9242

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146
Phone (410) 544-2500

8000 York Rd
Towson, MD 21252
Phone (410) 704-2000

1 Olympic Pl
Ste 200
Towson, MD 21204
Phone (410) 704-3095

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1942690797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "STE 111",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "410-544-2500",
            "fax_number": "410-384-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "STE 111",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "410-544-2500",
            "fax_number": "410-384-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSNELL",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TUCKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.