Individual provider Active NPI

Kristin Anne Ficco, OTR/L

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1265121362
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16483 Issued in NC
Practice address
1915 Randolph Rd FL 2
Charlotte, NC 28207-1101
Phone
(704) 323-3008
Fax
(704) 323-3979
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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 16483 NC Primary

Addresses

Primary practice location

1915 Randolph Rd FL 2
Charlotte, NC 28207-1101

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-3611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240418003744 NC Practitioner - Occupational Therapist in Private Practice 6507213360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Occupational Therapist CurrentSince Jan 15, 2024 Accepting new patients
Orthocarolina Occupational Therapist CurrentSince Jan 15, 2024 Accepting new patients
Foundation Health Systems LLC Occupational Therapist Past Accepting new patients

Locations

1915 Randolph Rd
Fl 2
Charlotte, NC 28207
Phone (704) 323-2426

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1265121362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 RANDOLPH RD FL 2",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071101",
            "telephone_number": "704-323-3008",
            "fax_number": "704-323-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICCO",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16483",
            "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 Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.