Organization Active NPI

D S Douglas Otr L LLC

  • Occupational Therapist
  • Black Mountain, NC
National Provider Identifier
1114104585
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1435 Issued in NC
Legal business name
D S DOUGLAS OTR L LLC
Practice address
130 Center Ave
Black Mountain, NC 28711-3509
Phone
(828) 338-9025
Fax
(888) 739-8184
NPI assigned
Jan 28, 2008
Last updated
Jul 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Mrs. Diane Douglas, OTR/LNPI 1811196371
Title
Occupational Therapist
Phone
(828) 338-9025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1435 NC Primary

Addresses

Primary practice location

130 Center Ave
Black Mountain, NC 28711-3509

Mailing address

538 Dye Leaf LN
Fairview, NC 28730-9652

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080208000500 NC Part B Supplier - Clinic/Group Practice 6002999380 Receives reassigned benefits from 1 practitioner
Practice locations: Black Mountain, NC

National Provider Directory

National Provider Directory

Locations

130 Center Ave
Black Mountain, NC 28711
Phone (828) 338-9025

411 W State St
Black Mtn, NC 28711
Phone (828) 669-8800

Practitioners & affiliated clinicians

Practitioners 3

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": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1114104585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 DYE LEAF LN",
            "city": "FAIRVIEW",
            "state": "NC",
            "postal_code": "287309652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CENTER AVE",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287113509",
            "telephone_number": "828-338-9025",
            "fax_number": "888-739-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D S DOUGLAS OTR L LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "828-338-9025",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "1435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.