NPIMap

Organization Active NPI

Pediatric Hands on Therapy, PC

  • Pediatric Occupational Therapist
  • Gastonia, NC
National Provider Identifier
1255456513
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
3364 Issued in NC
Legal business name
PEDIATRIC HANDS ON THERAPY, PC
Practice address
2557 Pembroke Rd
Gastonia, NC 28054-4712
Phone
(980) 320-8275
Fax
(704) 973-7862
NPI assigned
Mar 19, 2007
Last updated
Jan 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Authorized official

Name
Mrs. Freida Smith PoagNPI 1386792489
Title
President
Phone
(980) 320-8275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Pediatric Occupational Therapist 225XP0200X 3364 NC Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

2557 Pembroke Rd
Gastonia, NC 28054-4712

Mailing address

PO Box 1471
Belmont, NC 28012-1471
Phone (704) 747-3788

Other practice location 1

1308 Village Harbor Dr
Clover, SC 29710-9095
Phone (980) 320-8275

Other identifiers 1

IdentifierTypeStateIssuer
7212116MedicaidNC

National Provider Directory

National Provider Directory

Locations

2557 Pembroke Rd
Gastonia, NC 28054
Phone (704) 854-8887

1308 Village Harbor Dr
Clover, SC 29710
Phone (980) 320-8275

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1255456513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1471",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280121471",
            "telephone_number": "704-747-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 PEMBROKE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544712",
            "telephone_number": "980-320-8275",
            "fax_number": "704-973-7862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 Village Harbor Dr",
            "address_purpose": "LOCATION",
            "city": "Clover",
            "state": "SC",
            "postal_code": "297109095",
            "country_code": "US",
            "telephone_number": "980-320-8275",
            "fax_number": "704-973-7862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRIC HANDS ON THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "POAG",
        "authorized_official_first_name": "FREIDA",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "980-320-8275",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "3364",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212116",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.