Individual provider Active NPI

Taylor Jones Gullickson, OTR/L

  • Occupational Therapist
  • Spartanburg, SC
National Provider Identifier
1396240602
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5219 Issued in SC
Practice address
400 Webber Rd
Spartanburg, SC 29307-2400
Phone
(864) 579-7004
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5219 SC Primary
Occupational Therapist 225X00000X 14757 NC

Addresses

Primary practice location

400 Webber Rd
Spartanburg, SC 29307-2400

Mailing address

134 John Lancaster Rd
Spartanburg, SC 29306-6332
Phone (704) 883-6446

Other names 1

  • Taylor Jones Gullickson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250918000891 NC Practitioner - Occupational Therapist in Private Practice 8426552944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 W Jefferson St
Suite 2310
Louisville, KY 40202-2881

PO Box
Suite 69211
Baltimore, MD 21264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5219SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jul 8, 2025 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jul 8, 2025 Accepting new patients

Locations

2030 Windsor Run Ln
Matthews, NC 28105
Phone (704) 432-6250

1807 Windsor Run Ln
Matthews, NC 28105
Phone (704) 443-6200

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1396240602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 JOHN LANCASTER RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293066332",
            "telephone_number": "704-883-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEBBER RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072400",
            "telephone_number": "864-579-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLICKSON",
        "first_name": "TAYLOR",
        "middle_name": "JONES",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "5219",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "GULLICKSON",
            "middle_name": "JONES",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.