Individual provider Active NPI

Emily Mae Vanbortel, OTR/L

  • Occupational Therapist
  • Raeford, NC
National Provider Identifier
1083200885
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13442 Issued in NC
Practice address
1206 N Fulton St
Raeford, NC 28376-1926
Phone
(910) 875-4280
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13442 NC Primary

Addresses

Primary practice location

1206 N Fulton St
Raeford, NC 28376-1926

Mailing address

1485 Yellow Ribbon Dr Apt X
Fayetteville, NC 28314-3129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222003202 NC Practitioner - Occupational Therapist in Private Practice 1759754724 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13442NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Feb 7, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Feb 7, 2023 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

13600 S Tryon St
Charlotte, NC 28278
Phone (704) 587-9454

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1083200885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 YELLOW RIBBON DR APT X",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283143129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N FULTON ST",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283761926",
            "telephone_number": "910-875-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBORTEL",
        "first_name": "EMILY",
        "middle_name": "MAE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "13442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.