Individual provider Active NPI

Karen Blake Carmosino, OT

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1528484383
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9126 Issued in NC
Practice address
1915 Randolph Rd
Charlotte, NC 28207-1101
Phone
(704) 323-2000
NPI assigned
Mar 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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 9126 NC Primary

Addresses

Primary practice location

1915 Randolph Rd
Charlotte, NC 28207-1101

Mailing address

4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other names 1

  • Karen Rebecca Blake Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220308001101 GA Practitioner - Occupational Therapist in Private Practice 7113140484 Reassigns benefits to 1 organization
I20260522003000 AL Practitioner - Occupational Therapist in Private Practice 7113140484 Reassigns benefits to 1 organization
I20260528004168 FL Practitioner - Occupational Therapist in Private Practice 7113140484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

2860 Ronald Reagan Blvd
Suite 300
Cumming, GA 30041-6287
Phone (770) 977-7777

4012 N 9TH Ave
Pensacola, FL 32503-2824
Phone (850) 444-4777

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Orthopaedic Clinic PA Occupational Therapist CurrentSince Feb 28, 2022 Accepting new patients
Peachtree Orthopaedic Clinic CurrentSince Feb 28, 2022 Accepting new patients

Locations

11800 Amber Park Dr
Ste 200
Alpharetta, GA 30009

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

2860 Ronald Reagan Blvd
Ste 300
Cumming, GA 30041
Phone (404) 355-0742

Organizations & group practices 4

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": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1528484383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071101",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMOSINO",
        "first_name": "KAREN",
        "middle_name": "BLAKE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "9126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "BLAKE",
            "middle_name": "REBECCA",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.