Andrew St George Gladding, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

4590 Issued in NC

Practice address

200 Tabernacle Rd
Black Mountain, NC 28711-7733

Phone

(828) 357-2016

Fax

(828) 357-1098

NPI assigned

Sep 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506038400000",
    "number": "1154830149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FOREST RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032907",
            "telephone_number": "404-210-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TABERNACLE RD",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287117733",
            "telephone_number": "828-357-2016",
            "fax_number": "828-357-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADDING",
        "first_name": "ANDREW",
        "middle_name": "ST GEORGE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2017-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NC",
            "license": "4590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Black Mountain, NC
• Physical Rehabilitation Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; 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.