NPIMap

Organization Active NPI

Occupational Therapy South

  • Developmental Therapist
  • Waxhaw, NC
National Provider Identifier
1083898399
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
OCCUPATIONAL THERAPY SOUTH
Practice address
3022 Chisholm CT
Waxhaw, NC 28173-7865
Phone
(704) 843-2020
NPI assigned
Dec 21, 2007
Last updated
Dec 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Lauren Jennifer Mullan, M.A., OTR/L, ITFS-PNPI 1649358862
Title
Owner
Phone
(704) 843-2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NU
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

3022 Chisholm CT
Waxhaw, NC 28173-7865

Mailing address

3022 Chisholm CT
Waxhaw, NC 28173-7865
Phone (704) 843-2020

National Provider Directory

National Provider Directory
Tax ID family
Occupational Therapy South2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1083898399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 CHISHOLM CT",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737865",
            "telephone_number": "704-843-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 CHISHOLM CT",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737865",
            "telephone_number": "704-843-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL THERAPY SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "MULLAN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-843-2020",
        "authorized_official_credential": "M.A., OTR/L, ITFS-P"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.