Kristen Blair Cundiff, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

14201 Issued in NC

Practice address

210 Foxhall Road
Newport, NC 28570-5285

Phone

(252) 223-2560

NPI assigned

Apr 10, 2019

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1477016137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HICKORY DRIVE",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "28557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FOXHALL ROAD",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285705285",
            "telephone_number": "252-223-2560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4435 Pheasant Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240145285",
            "country_code": "US",
            "telephone_number": "540-904-4571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNDIFF",
        "first_name": "KRISTEN",
        "middle_name": "BLAIR",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131-002155",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "14201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Community Action, Inc.
• Coastal Pediatric Therapy Services
• Stacey Colborn
• Raymond C Conner Sr.
• Kirstie Corsan, M.S. CCC-SLP
• Meredith E. Czepiel
• Maurice F Dana, MD
• Matthew Davis
• Angeline Urban Demoret, PHARM.D
• Grace Ann Devlin, BCBA

• Occupational Therapy Assistant in Newport, NC
• Providers in Newport, NC by specialty
• Occupational Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.