Active NPI
Amanda Maire Tase, MS-OTR-L
- Occupational Therapist
- Mooresville, NC
National Provider Identifier
1346575321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7340
- Practice address
- 550 Glenwood Dr
Mooresville, NC 28115-2876 - Phone
- (704) 664-7494
- NPI assigned
- Oct 9, 2009
- 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 | 7340 | NC | Primary |
Addresses
Primary practice location
550 Glenwood Dr
Mooresville, NC 28115-2876
Mailing address
151 Waterlynn Ridge Rd
Mooresville, NC 28117-5433
Phone (716) 807-8692
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 |
|---|---|---|---|
| 7340 | NC | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255046400000",
"number": "1346575321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 WATERLYNN RIDGE RD",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281175433",
"telephone_number": "716-807-8692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 GLENWOOD DR",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281152876",
"telephone_number": "704-664-7494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TASE",
"first_name": "AMANDA",
"middle_name": "MAIRE",
"credential": "MS-OTR-L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-09",
"last_updated": "2009-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.