Active NPI
Ellie Czejkowski, MOT, OTR/L
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1306409693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12348
- Practice address
- 4201 Lake Boone TRL Ste 4
Raleigh, NC 27607-7511 - Phone
- (919) 781-4434
- NPI assigned
- Apr 22, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 12348 | NC | Primary |
Addresses
Primary practice location
4201 Lake Boone TRL Ste 4
Raleigh, NC 27607-7511
Mailing address
6329 Ashley Ridge Dr
Raleigh, NC 27612-6558
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 |
|---|---|---|---|
| 12348 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Associates | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1555891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1306409693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6329 ASHLEY RIDGE DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276126558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 LAKE BOONE TRL STE 4",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077511",
"telephone_number": "919-781-4434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZEJKOWSKI",
"first_name": "ELLIE",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-22",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "12348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.