Active NPI
Candace Folsom
- Occupational Therapist
- Fayetteville, NC
National Provider Identifier
1295161644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4206
- Practice address
- 1700 Pamalee Dr
Fayetteville, NC 28301-2824 - Phone
- (910) 488-8643
- Fax
- (910) 488-8644
- NPI assigned
- Sep 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4206 | NC | Primary |
Addresses
Primary practice location
1700 Pamalee Dr
Fayetteville, NC 28301-2824
Mailing address
3808 Burlington Dr
Fayetteville, NC 28312-7022
Phone (910) 578-0760
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 |
|---|---|---|---|
| 4206 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379376000000",
"number": "1295161644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3808 BURLINGTON DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283127022",
"telephone_number": "910-578-0760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 PAMALEE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283012824",
"telephone_number": "910-488-8643",
"fax_number": "910-488-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLSOM",
"first_name": "CANDACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-17",
"last_updated": "2013-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "4206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.