Active NPI
Larry Scott Maddy, OTR L CHT
- Occupational Therapist
- Eden, NC
National Provider Identifier
1487635934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1145
- Practice address
- 257 W Kings Hwy
Eden, NC 27288-5009 - Phone
- (336) 627-4263
- Fax
- (336) 627-4266
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1145 | NC | Primary |
| Hand Occupational Therapist | 225XH1200X | 9105000708 | NC |
Addresses
Primary practice location
257 W Kings Hwy
Eden, NC 27288-5009
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66985 | Other | MEDCOST | |
| 7301040 | Medicaid | NC | |
| 2510062C | Other | NC | MEDICARE OCCUPATIONAL THERAPY |
| 53709 | Other | NC | BCBS |
| 670000776 | Other | NC | MEDICARE RAILROAD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1145 | NC | MD | Pediatric Physical Therapist |
| 9105000708 | NC | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1487635934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8823 PRODUCTION LN",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373636511",
"telephone_number": "423-238-7217",
"fax_number": "423-954-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 W KINGS HWY",
"city": "EDEN",
"state": "NC",
"postal_code": "272885009",
"telephone_number": "336-627-4263",
"fax_number": "336-627-4266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDY",
"first_name": "LARRY",
"middle_name": "SCOTT",
"credential": "OTR L CHT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "1145",
"primary": true
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "NC",
"license": "9105000708",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "66985",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7301040",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE OCCUPATIONAL THERAPY",
"identifier": "2510062C",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "53709",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "670000776",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.