Individual provider Active NPI

Dresden Louise Grover, COTA/L

  • Occupational Therapy Assistant
  • Reidsville, NC
National Provider Identifier
1184813370
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1600 Issued in NC
Practice address
618 South Main St
Reidsville, NC 27320-0618
Phone
(336) 951-4557
Fax
(336) 951-4546
NPI assigned
Oct 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1600 NC Primary

Addresses

Primary practice location

618 South Main St
Reidsville, NC 27320-0618

Mailing address

7114 N River Rd
Oak Ridge, NC 27310-9827
Phone (336) 951-4557

Other identifiers 1

IdentifierTypeStateIssuer
010567MedicaidNC

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

LicenseStateTypeSpecialty
1600NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1184813370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7114 N RIVER RD",
            "city": "OAK RIDGE",
            "state": "NC",
            "postal_code": "273109827",
            "telephone_number": "336-951-4557",
            "fax_number": "336-951-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 SOUTH MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200618",
            "telephone_number": "336-951-4557",
            "fax_number": "336-951-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "DRESDEN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "1600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010567",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.