Individual provider Active NPI

Emily Ann Ivancic, OTR/L

  • Occupational Therapist
  • Morrisville, NC
National Provider Identifier
1306594700
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
5911 McCrimmon Pkwy
Morrisville, NC 27560-5944
Phone
(919) 473-6033
NPI assigned
Mar 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 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 NC Primary

Addresses

Primary practice location

5911 McCrimmon Pkwy
Morrisville, NC 27560-5944

Mailing address

5911 McCrimmon Pkwy
Morrisville, NC 27560-5944

Other practice location 1

10000 Cambridge Village Loop
Apex, NC 27502-7707
Phone (919) 473-6033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240130002770 NC Practitioner - Occupational Therapist in Private Practice 1557714193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
33 Health Opnc LLCGroup PAC ID 5890125108, 13 clinicians

Practice addresses (Care Compare)

5911 McCrimmon Pkwy
Suite 2a
Morrisville, NC 27560-5944
Phone (919) 473-6033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
33 Health Opnc LLC Occupational Therapist CurrentSince Jan 15, 2024 Accepting new patients

Locations

421 Overlook Road Ext
Arden, NC 28704
Phone (919) 473-6033

105 S Mangum St
#201
Durham, NC 27701
Phone (919) 473-6033

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1306594700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 MCCRIMMON PKWY",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 MCCRIMMON PKWY",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605944",
            "telephone_number": "919-473-6033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Cambridge Village Loop",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275027707",
            "country_code": "US",
            "telephone_number": "919-473-6033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANCIC",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.