Active NPI
Courtney Marie Fesette
- Occupational Therapist
- Mint Hill, NC
National Provider Identifier
1043973035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14523
- Practice address
- 10506 Clear Creek Commerce Dr
Mint Hill, NC 28227-7078 - Phone
- (704) 545-2377
- NPI assigned
- Oct 18, 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 | 14523 | NC | Primary |
Addresses
Primary practice location
10506 Clear Creek Commerce Dr
Mint Hill, NC 28227-7078
Mailing address
6705 Summergold Way
Charlotte, NC 28269-3197
Phone (980) 613-1797
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14523 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1043973035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6705 SUMMERGOLD WAY",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282693197",
"telephone_number": "980-613-1797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10506 CLEAR CREEK COMMERCE DR",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282277078",
"telephone_number": "704-545-2377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FESETTE",
"first_name": "COURTNEY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-18",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "14523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.