Active NPI
Kelsey Mauritz, OTR/L
- Occupational Therapist
- Fayetteville, NC
National Provider Identifier
1184182164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12163
- Practice address
- 1401 71St School Rd
Fayetteville, NC 28314-2814 - Phone
- (910) 867-4960
- NPI assigned
- Mar 8, 2019
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 8670-26 | WI | |
| Occupational Therapist | 225X00000X | OT61237394 | WA | |
| Occupational Therapist | 225X00000X | 7660 | TN | |
| Occupational Therapist | 225X00000X | OTH-009824 | AZ | |
| Occupational Therapist | 225X00000X | 410370 | OR | |
| Occupational Therapist | 225X00000X | 12163 | NC | Primary |
Addresses
Primary practice location
1401 71St School Rd
Fayetteville, NC 28314-2814
Mailing address
400 Forsythe St
Fayetteville, NC 28303
Phone (304) 573-5535
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-009824 | AZ | MD | Occupational Therapist |
| 410370 | OR | MD | Occupational Therapist |
| OT61237394 | WA | MD | Occupational Therapist |
| 8670-26 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1184182164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 FORSYTHE ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28303",
"telephone_number": "304-573-5535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 71ST SCHOOL RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283142814",
"telephone_number": "910-867-4960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAURITZ",
"first_name": "KELSEY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-08",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "8670-26",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT61237394",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "7660",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-009824",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "410370",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "12163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.