Active NPI
Emily Anne Dickens, OTR/L
- Occupational Therapist
- Winston Salem, NC
National Provider Identifier
1164945507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10957
- Practice address
- 1199 Hayes Forest Dr # D
Winston Salem, NC 27106-3377 - Phone
- (336) 759-1044
- NPI assigned
- Jul 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10957 | NC | Primary |
Addresses
Primary practice location
1199 Hayes Forest Dr # D
Winston Salem, NC 27106-3377
Mailing address
1104 Ebert St
Winston Salem, NC 27103-4412
Phone (859) 539-0225
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10957 | NC | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500336000000",
"number": "1164945507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 EBERT ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034412",
"telephone_number": "859-539-0225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 HAYES FOREST DR # D",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063377",
"telephone_number": "336-759-1044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKENS",
"first_name": "EMILY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-18",
"last_updated": "2017-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "10957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.