Active NPI
Laura Mary Fisher, OTR
- Occupational Therapist
- Cornelius, NC
National Provider Identifier
1306985775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7008
- Practice address
- 19215 Peninsula Shores Dr
Cornelius, NC 28031-7579 - Phone
- (703) 501-6366
- NPI assigned
- Feb 5, 2007
- 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 | 7008 | NC | Primary |
Addresses
Primary practice location
19215 Peninsula Shores Dr
Cornelius, NC 28031-7579
Mailing address
300 Sutro Forest Dr NW
Concord, NC 28027-8095
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12442285 | Other | CAQH | |
| 175CM | Other | NC | BCBS |
| 314668 | Other | VA | AMERIGROUP |
| 7302425 | Medicaid | NC | |
| 187840 | Other | VA | BLUE CROSS BLUE SHIELD |
| 0560 | Other | CIGNA | |
| 853461 | Other | OPTUMHEALTH |
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 |
|---|---|---|---|
| 7008 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H.O.P.E Therapeutics | Past | Accepting new patients | |
| Team Therapy Group | Past | Accepting new patients |
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.
-
- Pediatric Occupational Therapist
- Concord, NC
- NPI 1639635634
-
- Physical Therapist
- Cornelius, NC
- NPI 1972533883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1306985775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SUTRO FOREST DR NW",
"city": "CONCORD",
"state": "NC",
"postal_code": "280278095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19215 PENINSULA SHORES DR",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280317579",
"telephone_number": "703-501-6366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "LAURA",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7008",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12442285",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "175CM",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "314668",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7302425",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "187840",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0560",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUMHEALTH",
"identifier": "853461",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cornelius, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.