Individual provider Active NPI

Kathleen Smith Brannigan, OT/L

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1497487268
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2052 Issued in NC
Practice address
1019 Broomsedge Ter
Wilmington, NC 28412-1054
Phone
(336) 207-4410
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 2052 NC Primary

Addresses

Primary practice location

1019 Broomsedge Ter
Wilmington, NC 28412-1054

Mailing address

1019 Broomsedge Ter
Wilmington, NC 28412-1054
Phone (336) 207-4410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014002278 NC Practitioner - Occupational Therapist in Private Practice 8820520075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

1935 Lincoln Rd NE
C/O the Bluefields
Leland, NC 28451-9187
Phone (910) 550-3814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2052NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC Single Specialty CurrentSince Aug 17, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Aug 17, 2024 Accepting new patients

Locations

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

1935 Lincoln Rd NE
Leland, NC 28451
Phone (910) 383-6235

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

Organizations & group practices 2

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1497487268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 BROOMSEDGE TER",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121054",
            "telephone_number": "336-207-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 BROOMSEDGE TER",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121054",
            "telephone_number": "336-207-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNIGAN",
        "first_name": "KATHLEEN",
        "middle_name": "SMITH",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.