Individual provider Active NPI

Quenicia Nobles Starks, MSOT, OTR/L

  • Gerontology Occupational Therapist
  • Fayetteville, NC
National Provider Identifier
1447720990
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
10796 Issued in NC
Practice address
2300 Ramsey St
Fayetteville, NC 28301-3856
Phone
(910) 488-2021
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XG0600X 10796 NC Primary

Addresses

Primary practice location

2300 Ramsey St
Fayetteville, NC 28301-3856

Mailing address

1901 Robert Luke Dr NE
Leland, NC 28451-9297
Phone (252) 876-5052

Other practice location 1

7011 Gum Branch Rd
Richlands, NC 28574-8227
Phone (910) 430-2201

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
10796NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow County Schools Multi-Specialty Past Accepting new patients
Pro Step Therapy Inc Multi-Specialty PastSince Sep 1, 2015 Accepting new patients
Move, Learn, Play, Inc. Multi-Specialty PastSince Jan 15, 2016 Accepting new patients

Organizations & group practices 3

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1447720990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 ROBERT LUKE DR NE",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519297",
            "telephone_number": "252-876-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-488-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7011 Gum Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "NC",
            "postal_code": "285748227",
            "country_code": "US",
            "telephone_number": "910-430-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARKS",
        "first_name": "QUENICIA",
        "middle_name": "NOBLES",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NC",
            "license": "10796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.