Active NPI
Rebecca Lanelle Harris, COTA/L
- Occupational Therapy Assistant
- Kingstree, SC
National Provider Identifier
1053709345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3394
- Practice address
- 1248 N Longstreet St
Kingstree, SC 29556-2748 - Phone
- (843) 354-7529
- Fax
- (843) 382-7542
- NPI assigned
- Jan 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 3394 | SC | Primary |
Addresses
Primary practice location
1248 N Longstreet St
Kingstree, SC 29556-2748
Mailing address
109 Whitesville Rd
Moncks Corner, SC 29461-2626
Phone (843) 729-1605
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 |
|---|---|---|---|
| 3394 | SC | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420675200000",
"number": "1053709345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 WHITESVILLE RD",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294612626",
"telephone_number": "843-729-1605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1248 N LONGSTREET ST",
"city": "KINGSTREE",
"state": "SC",
"postal_code": "295562748",
"telephone_number": "843-354-7529",
"fax_number": "843-382-7542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "REBECCA",
"middle_name": "LANELLE",
"name_prefix": "Miss",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-08",
"last_updated": "2015-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingstree, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.