Active NPI
Maegan Lyn Gillooly, MOT, OTR/L
- Occupational Therapist
- Mooresville, NC
National Provider Identifier
1174809073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11310
- Practice address
- 134 Infield CT
Mooresville, NC 28117-8026 - Phone
- (704) 799-6824
- Fax
- (704) 799-6825
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 11310 | NC | Primary |
Addresses
Primary practice location
134 Infield CT
Mooresville, NC 28117-8026
Mailing address
134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824
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 |
|---|---|---|---|
| 11310 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Therapy Concepts | Multi-Specialty | Past | Accepting new patients |
| Lolly Therapeutics, LLC | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Occupational Therapist
- Mooresville, NC
- NPI 1508849332
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507680000000",
"number": "1174809073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 INFIELD CT",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281178026",
"telephone_number": "704-799-6824",
"fax_number": "704-799-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 INFIELD CT",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281178026",
"telephone_number": "704-799-6824",
"fax_number": "704-799-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLOOLY",
"first_name": "MAEGAN",
"middle_name": "LYN",
"credential": "MOT, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2017-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.