Active NPI
Carly Rochelle Maready
- Occupational Therapist
- Jacksonville, NC
National Provider Identifier
1003579368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14495
- Practice address
- 101 N Plain Rd
Jacksonville, NC 28546-6760 - Phone
- (910) 502-8738
- NPI assigned
- Oct 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14495 | NC | Primary |
Addresses
Primary practice location
101 N Plain Rd
Jacksonville, NC 28546-6760
Mailing address
122 Brinkley LN
Jacksonville, NC 28546-9295
Phone (910) 934-4726
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1003579368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 BRINKLEY LN",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469295",
"telephone_number": "910-934-4726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N PLAIN RD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466760",
"telephone_number": "910-502-8738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAREADY",
"first_name": "CARLY",
"middle_name": "ROCHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-14",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "14495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.