Individual provider Active NPI

Amber Balandis

  • Occupational Therapist
  • Erie, PA
National Provider Identifier
1972051910
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC014598 Issued in PA
Practice address
4950 W 23Rd St
Suite 1
Erie, PA 16506-5802
Phone
(814) 459-2755
Fax
(814) 456-4873
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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 OC014598 PA Primary

Addresses

Primary practice location

4950 W 23Rd St
Suite 1
Erie, PA 16506-5802

Mailing address

4950 W 23Rd St
Suite 1
Erie, PA 16506-5802
Phone (814) 459-2755

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

LicenseStateTypeSpecialty
OC014598PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1972051910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 W 23RD ST",
            "address_2": "SUITE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165065802",
            "telephone_number": "814-459-2755",
            "fax_number": "814-456-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 W 23RD ST",
            "address_2": "SUITE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165065802",
            "telephone_number": "814-459-2755",
            "fax_number": "814-456-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALANDIS",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC014598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.