Active NPI
Katherine Gayle Womble
- Occupational Therapist
- Fayetteville, NC
National Provider Identifier
1194393835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14099
- Practice address
- 5948 Fisher Rd
Fayetteville, NC 28304-5640 - Phone
- (910) 423-5622
- Fax
- (910) 378-1755
- NPI assigned
- Jun 17, 2021
- 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 | 14099 | NC | Primary |
Addresses
Primary practice location
5948 Fisher Rd
Fayetteville, NC 28304-5640
Mailing address
4602 Cumberland Rd
Fayetteville, NC 28306-2412
Phone (910) 423-5622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467433680 | Medicaid | NC |
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 |
|---|---|---|---|
| 14099 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1194393835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4602 CUMBERLAND RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283062412",
"telephone_number": "910-423-5622",
"fax_number": "910-378-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5948 FISHER RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283045640",
"telephone_number": "910-423-5622",
"fax_number": "910-378-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMBLE",
"first_name": "KATHERINE",
"middle_name": "GAYLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "14099",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467433680",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
- Wolinsky Primary Care, PA
- Sidney P. Wolinsky, PA-C
- Womack Army Medical Center (Fayetteville Medical Home-Bragg)
- Donna Jane Womack-Miller, MSW, LCSW
- Jessica Samantha Womble, PA
- Katlyn Womble, PHARMD
- Womens Health Haven Obstetrics and Gynecology
- Womens Wellness Center, P.a.
- Ashley Wongk, M.D.
- Haeyoon Sun Woo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.