Individual provider Active NPI

Abigail Villanueva, OTR L

  • Occupational Therapist
  • Indian Trail, NC
National Provider Identifier
1417115346
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6772 Issued in NC
Practice address
598 Indian Trail Rd S
141
Indian Trail, NC 28079-8689
Phone
(704) 975-7008
Fax
(704) 821-0570
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 6772 NC Primary

Addresses

Primary practice location

598 Indian Trail Rd S
141
Indian Trail, NC 28079-8689

Mailing address

598 Indian Trail Rd S
141
Indian Trail, NC 28079-8689
Phone (704) 975-7008

Other practice location 1

20821 US Highway 18
Apple Valley, CA 92307-3549
Phone (760) 686-8000

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
6772NCMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1417115346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 INDIAN TRAIL RD S",
            "address_2": "141",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798689",
            "telephone_number": "704-975-7008",
            "fax_number": "704-821-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 INDIAN TRAIL RD S",
            "address_2": "141",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798689",
            "telephone_number": "704-975-7008",
            "fax_number": "704-821-0570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20821 US Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923073549",
            "country_code": "US",
            "telephone_number": "760-686-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ABIGAIL",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.