Individual provider Active NPI

Caroline Brown, COTA

  • Occupational Therapy Assistant
  • Winston Salem, NC
National Provider Identifier
1457940397
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
12637 Issued in NC
Practice address
190 Moravian Way Dr
Winston Salem, NC 27106-3216
Phone
(336) 767-8130
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 12637 NC Primary

Addresses

Primary practice location

190 Moravian Way Dr
Winston Salem, NC 27106-3216

Mailing address

602 Frontier Cir
China Grove, NC 28023-9488
Phone (704) 792-5348

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
12637NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1457940397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 FRONTIER CIR",
            "city": "CHINA GROVE",
            "state": "NC",
            "postal_code": "280239488",
            "telephone_number": "704-792-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 MORAVIAN WAY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063216",
            "telephone_number": "336-767-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAROLINE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "12637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.