NPIMap

Organization Active NPI

Eastern Therapy Solutions, PLLC

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1073143343
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
EASTERN THERAPY SOLUTIONS, PLLC
Practice address
9020 Senca Dr Ste 220
Wilmington, NC 28411-6680
Phone
(252) 227-0251
Fax
(910) 442-8372
NPI assigned
Jan 24, 2020
Last updated
May 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Authorized official

Name
Brooke WallaceNPI 1760025043
Title
Owner
Phone
(252) 227-0251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X
Occupational Therapist 225X00000X Primary
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

9020 Senca Dr Ste 220
Wilmington, NC 28411-6680

Mailing address

9020 Senca Dr Ste 220
Wilmington, NC 28411-6680
Phone (252) 227-0251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201111000167 NC Part B Supplier - Clinic/Group Practice 7113337700 Receives reassigned benefits from 21 practitioners
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

740 Greenville Blvd SE
Ste 400
Greenville, NC 27858
Phone (252) 361-8960

9020 Senca Dr
Ste 220
Wilmington, NC 28411
Phone (910) 264-9317

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1073143343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR STE 220",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116680",
            "telephone_number": "252-227-0251",
            "fax_number": "910-442-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR STE 220",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116680",
            "telephone_number": "252-227-0251",
            "fax_number": "910-442-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN THERAPY SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-05-03",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-227-0251"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.