Providence Therapy, PA

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5459 Issued in NC

Legal business name

PROVIDENCE THERAPY, PA

Practice address

320 Hallwood CT
Holly Springs, NC 27540-8753

Phone

(919) 341-1166

NPI assigned

Feb 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah M Wood, OTR L

Title

President

Phone

(919) 341-1166

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467590034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4431",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275194431",
            "telephone_number": "919-341-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 HALLWOOD CT",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408753",
            "telephone_number": "919-341-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE THERAPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-341-1166",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "5459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211619",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren E Powell, OTR/L
• Sarah Carmany Powell, PTA
• Precious Family Care Home LLC
• Premier Psychiatric Services, PLLC
• Private Diagnostic Clinic, PLLC
• Samuel Puleio, PHARM.D.
• Faith Purdie
• Stephanie Ann Putkowski Augustus, OTR/L
• Jennifer A Putt, LCSW
• Jennifer Mary Putzi, LCMHC-A

• Pediatric Occupational Therapist in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Pediatric Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.