Individual provider Active NPI

Savannah Grace Fletcher

  • Occupational Therapy Assistant
  • North Charleston, SC
National Provider Identifier
1043931835
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5423 Issued in SC
Practice address
2070 Northbrook Blvd Ste B4
North Charleston, SC 29406-9254
Phone
(843) 569-3033
Fax
(843) 569-6820
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5423 SC Primary

Addresses

Primary practice location

2070 Northbrook Blvd Ste B4
North Charleston, SC 29406-9254

Mailing address

100 Manigault Dr
Summerville, SC 29483-3771
Phone (616) 581-8741

Other practice location 1

1064 Gardner Rd Ste 101
Charleston, SC 29407-5711
Phone (843) 769-0663

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
5423SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Pediatric Rehabilitation PastSince Sep 11, 2022 Accepting new patients
Charleston Pediatric Rehabilitation LLC PastSince Sep 11, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1043931835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MANIGAULT DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294833771",
            "telephone_number": "616-581-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD STE B4",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069254",
            "telephone_number": "843-569-3033",
            "fax_number": "843-569-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1064 Gardner Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294075711",
            "country_code": "US",
            "telephone_number": "843-769-0663",
            "fax_number": "843-769-0665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "SAVANNAH",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.

Verify at the official NPI Registry.