Individual provider Active NPI

Rebecca Obendorf, OTR/L

  • Occupational Therapist
  • Winston Salem, NC
National Provider Identifier
1356972632
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11599 Issued in NC
Practice address
661 Valley Brook LN
Winston Salem, NC 27104-2732
Phone
(336) 671-9384
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 11599 NC Primary

Addresses

Primary practice location

661 Valley Brook LN
Winston Salem, NC 27104-2732

Mailing address

661 Valley Brook LN
Winston Salem, NC 27104-2732
Phone (336) 671-9384

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

LicenseStateTypeSpecialty
11599NCMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1356972632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 VALLEY BROOK LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271042732",
            "telephone_number": "336-671-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 VALLEY BROOK LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271042732",
            "telephone_number": "336-671-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENDORF",
        "first_name": "REBECCA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.