NPIMap

Organization Active NPI

Imagination Therapy PLLC

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1407039894
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5739 Issued in NC
Legal business name
IMAGINATION THERAPY PLLC
Practice address
1179 Harp St
Raleigh, NC 27604-1303
Phone
(919) 324-1881
Fax
(919) 324-1781
NPI assigned
Dec 10, 2007
Last updated
Nov 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Ms. Sunita Murty-Gami, MS OTRL ITFSNPI 1346255163
Title
Manager Occupational Therapist
Phone
(314) 749-9654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X NU
Occupational Therapist 225X00000X 5739 NC Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1179 Harp St
Raleigh, NC 27604-1303

Mailing address

1179 Harp St
Raleigh, NC 27604-1303
Phone (919) 324-1881

Other identifiers 2

IdentifierTypeStateIssuer
019W4OtherNCBCBS
7200132MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Imagination Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1407039894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 HARP ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041303",
            "telephone_number": "919-324-1881",
            "fax_number": "919-324-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 HARP ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041303",
            "telephone_number": "919-324-1881",
            "fax_number": "919-324-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINATION THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "MURTY-GAMI",
        "authorized_official_first_name": "SUNITA",
        "authorized_official_title_or_position": "MANAGER OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "314-749-9654",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS OTRL ITFS"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5739",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019W4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200132",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.