Mary Ragan Wiseman
Individual provider Active NPI Occupational Therapist · Charlotte, NC
NPI 1376324079 · NPPES record last updated Oct 9, 2023
Key facts
- NPI
- 1376324079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 16342 (NC)
- Practice address
- 620 Tom Hunter Rd
Charlotte, NC 28213-5511 - Phone
- (704) 589-5136
- NPI assigned
- Oct 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Weston Group Inc
Collective Therapy Corp
Practice addresses (Care Compare)
1251 E Hudson Blvd
Gastonia, NC 28054-6102
Phone (704) 865-5556
507 Wakefield Dr
Apt C
Charlotte, NC 28209-3148
Phone (704) 285-8207
7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333
980 Chestnut LN
Matthews, NC 28104-8543
Phone (980) 585-9293
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251024002236 | NC | Practitioner - Occupational Therapist in Private Practice | 3375031883 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16342 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collective Therapy Corp. | Occupational Therapist | Current |
Accepting new patients |
| The Weston Group Inc. | Current |
Accepting new patients | |
| The Weston Group Inc | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 16342 | NC | Yes |
Addresses
Primary practice location
620 Tom Hunter Rd
Charlotte, NC 28213-5511
Mailing address
221 N Locust St
Floyd, VA 24091-2106
Phone (540) 250-7888
Other providers in Charlotte, NC
- Khysha Le Wise
- Leah Wise
- Michelle Wise
- Valarie Wise
- Kristin Tera Wiseman
- Ryan Wishart
- Joel A Wissing
- Wisteria Counseling and Consulting
- Hannah Witcher
- With Grace Case Management
All providers in Charlotte, NC · Occupational Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.