Individual provider Active NPI

Peter Evan Brown, COTA/L

  • Low Vision Occupational Therapy Assistant
  • Charlotte, NC
National Provider Identifier
1255732087
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Occupational Therapy AssistantTaxonomy code 224ZL0004X
License
9300 Issued in NC
Practice address
704 Louise Ave
Charlotte, NC 28204-2128
Phone
(180) 092-6456
NPI assigned
Sep 11, 2014
Last updated
Sep 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
9300NCMDLow 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.

Verify at the official NPI Registry.