Active NPI
Colleen Rose, MOTR
- Occupational Therapist
- Wilmington, NC
National Provider Identifier
1508141888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 8556
- Practice address
- 219 Racine Dr
Suite 1-a
Wilmington, NC 28403-8827 - Phone
- (910) 792-6706
- Fax
- (910) 792-6706
- NPI assigned
- Oct 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 8556 | NC | Primary |
Addresses
Primary practice location
219 Racine Dr
Suite 1-a
Wilmington, NC 28403-8827
Mailing address
541 Sandridge Rd
Hubert, NC 28539-4362
Phone (732) 599-4813
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8556 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Kids Therapy PLLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Wilmington, NC
- NPI 1669732079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366070400000",
"number": "1508141888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 SANDRIDGE RD",
"city": "HUBERT",
"state": "NC",
"postal_code": "285394362",
"telephone_number": "732-599-4813",
"fax_number": "910-792-6706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 RACINE DR",
"address_2": "SUITE 1-A",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038827",
"telephone_number": "910-792-6706",
"fax_number": "910-792-6706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "COLLEEN",
"credential": "MOTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-18",
"last_updated": "2013-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "8556",
"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 Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.