Active NPI
Anna Dediemar, OTR/L
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1336771583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17188
- Practice address
- 9200 Glenwater Dr
Charlotte, NC 28262-8557 - Phone
- (704) 549-0807
- NPI assigned
- Feb 5, 2020
- Last updated
- Oct 28, 2024
- 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 | 17188 | NC | Primary |
Addresses
Primary practice location
9200 Glenwater Dr
Charlotte, NC 28262-8557
Mailing address
10215 Caldwell Depot Rd
Cornelius, NC 28031-8119
Phone (513) 543-5739
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 |
|---|---|---|---|
| 17188 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Group East, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1336771583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10215 CALDWELL DEPOT RD",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280318119",
"telephone_number": "513-543-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 GLENWATER DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282628557",
"telephone_number": "704-549-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDIEMAR",
"first_name": "ANNA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-05",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "17188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Dedicated 2 Liberating, LLC
- Dedicated Caregivers LLC
- Dedicated Caregivers LLC
- Dedicated Physicians Group of North Carolina PLLC (Dedicated Senior Medical Center Rockwell)
- Dedicated Physicians Group of North Carolina PLLC (Dedicated Senior Medical Center Sheffield Park)
- Dee Veggie Chef & Rd, LLC
- Dee Veggie Nutrition
- Sherry Beth Deedrick
- Morgan Ciara Deehan
- Donald Ellis Deep, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.