Christine Marie Berube, OT – Occupational Therapist

Key facts

NPI: 1992007645
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: 06604 (MD)
Practice address: 130 Hospital Rd
Suite 130
Prince Frederick, MD 20678-4015
Phone: (410) 535-8180
Fax: (410) 535-8325
NPI assigned: Dec 1, 2010
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
06604	MD	MD	Occupational Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	06604	MD	Yes

Addresses

Primary practice location

130 Hospital Rd
Suite 130
Prince Frederick, MD 20678-4015

Mailing address

130 Hospital Rd
Suite 130
Prince Frederick, MD 20678-4015
Phone (410) 535-8180

Other identifiers

Identifier	Type	State	Issuer
406409700	Medicaid	MD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 30, 2012.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1992007645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL RD",
            "address_2": "SUITE 130",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784015",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL RD",
            "address_2": "SUITE 130",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784015",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERUBE",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406409700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

All providers in Prince Frederick, MD · Occupational Therapist in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.