Active NPI
Ashley Samantha Kizzie, M.S., OTR/L
- Occupational Therapist
- Colfax, NC
National Provider Identifier
1043852684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11607
- Practice address
- 1575 John Knox Dr
Colfax, NC 27235-9662 - Phone
- (336) 668-4900
- NPI assigned
- Oct 15, 2019
- 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 | 11607 | NC | Primary |
Addresses
Primary practice location
1575 John Knox Dr
Colfax, NC 27235-9662
Mailing address
709 Trifecta CT
Whitsett, NC 27377-8786
Phone (910) 916-4760
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11607 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1043852684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 TRIFECTA CT",
"city": "WHITSETT",
"state": "NC",
"postal_code": "273778786",
"telephone_number": "910-916-4760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 JOHN KNOX DR",
"city": "COLFAX",
"state": "NC",
"postal_code": "272359662",
"telephone_number": "336-668-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIZZIE",
"first_name": "ASHLEY",
"middle_name": "SAMANTHA",
"credential": "M.S., OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-15",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colfax, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.