Individual provider Active NPI

Elizabeth Ann Locke, OTR/L

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1144403973
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11912 Issued in NC
Practice address
414 Chablis Way
Wilmington, NC 28411-8758
Phone
(443) 994-6711
NPI assigned
Dec 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 05286 MD
Occupational Therapist 225X00000X 11912 NC Primary

Addresses

Primary practice location

414 Chablis Way
Wilmington, NC 28411-8758

Mailing address

414 Chablis Way
Wilmington, NC 28411-8758
Phone (443) 994-6711

Other practice location 1

4130 Oleander Dr Ste 101
Wilmington, NC 28403
Phone (910) 679-8385

Other names 1

  • Elizabeth Ann Ware Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210819000593 NC Practitioner - Occupational Therapist in Private Practice 1153726815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

414 Chablis Way
Wilmington, NC 28411-8758
Phone (443) 994-6711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Independence Therapy, PLLC CurrentSince Aug 11, 2021 Accepting new patients
Coastline Therapy Group, LLC Occupational Therapist PastSince Nov 17, 2018 Accepting new patients
Coastal Speech and Reading Center Past Accepting new patients

Organizations & group practices 3

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": "1197676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1144403973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 CHABLIS WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118758",
            "telephone_number": "443-994-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 CHABLIS WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118758",
            "telephone_number": "443-994-6711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4130 Oleander Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "28403",
            "country_code": "US",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-15",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "05286",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WARE",
            "middle_name": "ANN",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.