Active NPI
Peter Evan Brown, COTA/L
- Low Vision Occupational Therapy Assistant
- Charlotte, NC
National Provider Identifier
1255732087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Low Vision Occupational Therapy Assistant
- License
- 9300
- Practice address
- 704 Louise Ave
Charlotte, NC 28204-2128 - Phone
- (180) 092-6456
- NPI assigned
- Sep 11, 2014
- Last updated
- Sep 11, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 9300 | NC | |
| Low Vision Occupational Therapy Assistant | 224ZL0004X | 9300 | NC | Primary |
Addresses
Primary practice location
704 Louise Ave
Charlotte, NC 28204-2128
Mailing address
704 Louise Ave
Charlotte, NC 28204-2128
Phone (180) 092-6456
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 |
|---|---|---|---|
| 9300 | NC | MD | Low Vision Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1255732087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 LOUISE AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042128",
"telephone_number": "180-092-6456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 LOUISE AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042128",
"telephone_number": "180-092-6456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "PETER",
"middle_name": "EVAN",
"name_prefix": "Mr.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-11",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "9300",
"primary": false
},
{
"code": "224ZL0004X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Low Vision",
"state": "NC",
"license": "9300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.