Individual provider Active NPI

Kaitlyn Schafer, OTR/L

  • Occupational Therapist
  • Wake Forest, NC
National Provider Identifier
1114794161
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13756 Issued in NC
Practice address
900 S Franklin St Ste 201
Wake Forest, NC 27587-2799
Phone
(919) 556-1245
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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 13756 NC Primary

Addresses

Primary practice location

900 S Franklin St Ste 201
Wake Forest, NC 27587-2799

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
13756NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Physical Therapy, LLC Occupational Therapist CurrentSince Dec 11, 2023 Accepting new patients

Locations

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2009 Neuse Blvd
New Bern, NC 28560
Phone (252) 636-9800

900 S Franklin St
Ste 201
Wake Forest, NC 27587
Phone (919) 556-1245

Organizations & group practices 1

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": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1114794161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S FRANKLIN ST STE 201",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872799",
            "telephone_number": "919-556-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "KAITLYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "13756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.