Active NPI
Alexis Petteway
- Physical Rehabilitation Occupational Therapist
- Chapel Hill, NC
National Provider Identifier
1508341025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 12062
- Practice address
- 101 Manning Dr
Chapel Hill, NC 27514-4220 - Phone
- (984) 974-0209
- NPI assigned
- Oct 1, 2018
- Last updated
- Oct 1, 2018
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 12062 | NC | Primary |
Addresses
Primary practice location
101 Manning Dr
Chapel Hill, NC 27514-4220
Mailing address
10715 Summerton Dr
Raleigh, NC 27614-8628
Phone (919) 605-0231
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 |
|---|---|---|---|
| 12062 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1508341025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10715 SUMMERTON DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148628",
"telephone_number": "919-605-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MANNING DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275144220",
"telephone_number": "984-974-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTEWAY",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "NC",
"license": "12062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.