Individual provider Active NPI

Joleen Antonia Andrews, OT/L

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1508102161
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5447 Issued in NC
Practice address
3504 Diamond Springs Dr
Raleigh, NC 27610-2481
Phone
(336) 624-2937
NPI assigned
Dec 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5447 NC Primary

Addresses

Primary practice location

3504 Diamond Springs Dr
Raleigh, NC 27610-2481

Mailing address

3504 Diamond Springs Dr
Raleigh, NC 27610-2481
Phone (336) 624-2937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230214001965 NC Practitioner - Occupational Therapist in Private Practice 5890167142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Dec 1, 2023 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Dec 1, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3113 Charles B Root Wynd
Raleigh, NC 27612

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": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1508102161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 DIAMOND SPRINGS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102481",
            "telephone_number": "336-624-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 DIAMOND SPRINGS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102481",
            "telephone_number": "336-624-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "JOLEEN",
        "middle_name": "ANTONIA",
        "name_prefix": "Mrs.",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.