Individual provider Active NPI

Theresa McCauley, OT

  • Occupational Therapist
  • Elizabeth City, NC
National Provider Identifier
1205130747
Registry record updated Dec 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6103 Issued in NC
Practice address
1075 US Highway 17 S
Elizabeth City, NC 27909-7628
Phone
(252) 338-3975
NPI assigned
Dec 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6103 NC Primary

Addresses

Primary practice location

1075 US Highway 17 S
Elizabeth City, NC 27909-7628

Mailing address

128 Marino PL
Clayton, NC 27527-3959
Phone (919) 763-9400

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
6103NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1293148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293148800000",
    "number": "1205130747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MARINO PL",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275273959",
            "telephone_number": "919-763-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 US HIGHWAY 17 S",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097628",
            "telephone_number": "252-338-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "THERESA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-24",
        "last_updated": "2010-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2010; 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.