Thera-Play Pediatric Services

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1719 Issued in NC

Legal business name

THERA-PLAY PEDIATRIC SERVICES

Practice address

201 Woodlawn Dr
Williamston, NC 27892-1756

Phone

(252) 809-9389

Fax

(252) 792-1002

NPI assigned

Aug 5, 2009

Organization subpart

No

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

Authorized official

Name

Kimberly Roberson Stevens, OTR/LNPI 1033357900

Title

Occupational Therapist

Phone

(252) 809-9389

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Roberson Stevens, OTR/L

  • Occupational Therapist
  • Williamston, NC
  • NPI 1033357900
  NPD Authorized official

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1508097734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WOODLAWN DR",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278921756",
            "telephone_number": "252-809-9389",
            "fax_number": "252-792-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WOODLAWN DR",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278921756",
            "telephone_number": "252-809-9389",
            "fax_number": "252-792-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA-PLAY PEDIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ROBERSON",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "252-809-9389",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "1719",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "1719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Williamston, NC
• Pediatric Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.