Individual provider Active NPI

Cassandra Maria Spivey-Johnson

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1003066820
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6979 Issued in NC
Practice address
1130 Falls River Ave
Raleigh, NC 27614-7772
Phone
(919) 803-2912
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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 6979 NC Primary

Addresses

Primary practice location

1130 Falls River Ave
Raleigh, NC 27614-7772

Mailing address

108 S Dixon Ave
Cary, NC 27511-3202
Phone (919) 815-1195

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
6979NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1003066820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S DIXON AVE",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113202",
            "telephone_number": "919-815-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 FALLS RIVER AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147772",
            "telephone_number": "919-803-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY-JOHNSON",
        "first_name": "CASSANDRA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.