Individual provider Active NPI

Katlyn Maiolo, OT-OHT

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1306450408
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
15747 Issued in NC
Practice address
3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243
Phone
(919) 863-6856
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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 15747 NC Primary

Addresses

Primary practice location

3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243

Mailing address

2708 Enville CT
Wake Forest, NC 27587-5253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230310002718 NC Practitioner - Occupational Therapist in Private Practice 8527431600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Orthopaedic Clinic PAGroup PAC ID 9032012638, 125 clinicians

Practice addresses (Care Compare)

3001 Edwards Mill Rd
Suite 200
Raleigh, NC 27612-5243
Phone (919) 863-6856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Orthopaedic Clinic PA CurrentSince Feb 20, 2023 Accepting new patients
Raleigh Orthopaedic Pharmacy CurrentSince Feb 20, 2023 Accepting new patients

Locations

1325 Timber Dr E
Garner, NC 27529
Phone (919) 863-6856

3515 Glenwood Ave
Raleigh, NC 27612
Phone 91978156006856

3001 Edwards Mill Rd
Ste 200
Raleigh, NC 27612
Phone (919) 863-6852

Organizations & group practices 2

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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1306450408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 ENVILLE CT",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-863-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIOLO",
        "first_name": "KATLYN",
        "credential": "OT-OHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "15747",
            "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 Feb 21, 2023; 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.