Active NPI
Brett Terill Duffey Sr., OT L
- Occupational Therapist
- Clemmons, NC
National Provider Identifier
1336126382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3857
- Practice address
- 6000 Meadowbrook Mall CT
Suite #22
Clemmons, NC 27012-8112 - Phone
- (336) 778-0292
- Fax
- (336) 778-0292
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- 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 | 3857 | NC | Primary |
Addresses
Primary practice location
6000 Meadowbrook Mall CT
Suite #22
Clemmons, NC 27012-8112
Mailing address
6000 Meadowbrook Mall
Suite #22
Clemmons, NC 27012-8977
Phone (336) 778-0292
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10378967 | Other | NC | NC VOCATIONAL REHAB |
| 11-3670557 | Other | NC | CIGNA HEALTHCARE |
| 805848 | Other | NC | PAARTNERS |
| E2197 | Other | NC | MEDCOST PREFERRED |
| 0517000 | Other | NC | UNITED HEALTH CARE |
| 10378967 | Other | NC | NC VOCATIONAL REHABILITAT |
| 135VA | Other | NC | BCBSNC |
| 64-01026 | Other | NC | SECURE HORIZONS |
| 805848 | Other | NC | PARTNERS |
| 691687 | Other | NC | ACN GROUP |
| BA1238 | Other | NC | MEDCOST |
| 007517787 | Other | NC | AETNA |
| 136VA | Other | NC | BCBSNC |
| 7301751 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3857 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Rehab | Occupational Therapist | Current | Accepting new patients |
Locations
6000 Meadowbrook Mall Ct
Ste 22
Clemmons, NC 27012
Phone (336) 778-0292
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.
-
- Occupational Therapist
- Clemmons, NC
- NPI 1699967547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1336126382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6000 MEADOWBROOK MALL",
"address_2": "SUITE #22",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270128977",
"telephone_number": "336-778-0292",
"fax_number": "336-778-0292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 MEADOWBROOK MALL CT",
"address_2": "SUITE #22",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270128112",
"telephone_number": "336-778-0292",
"fax_number": "336-778-0292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFFEY",
"first_name": "BRETT",
"middle_name": "TERILL",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "OT L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "3857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC VOCATIONAL REHAB",
"identifier": "10378967",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "11-3670557",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PAARTNERS",
"identifier": "805848",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST PREFERRED",
"identifier": "E2197",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "0517000",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC VOCATIONAL REHABILITAT",
"identifier": "10378967",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "135VA",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURE HORIZONS",
"identifier": "64-01026",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "805848",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN GROUP",
"identifier": "691687",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "BA1238",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "007517787",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "136VA",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7301751",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clemmons, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.