Individual provider Active NPI

Amy May Collishaw

  • Occupational Therapist
  • Durham, NC
National Provider Identifier
1528619319
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11285 Issued in NC
Practice address
3000 Erwin Rd
Durham, NC 27705-4504
Phone
(919) 684-5154
NPI assigned
Sep 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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 11285 NC Primary

Addresses

Primary practice location

3000 Erwin Rd
Durham, NC 27705-4504

Mailing address

3000 Erwin Rd
Durham, NC 27705-4504
Phone (919) 684-5154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216002904 NC Practitioner - Occupational Therapist in Private Practice 3072947506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11285NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. Current Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3000 Erwin Rd
Durham, NC 27705
Phone (919) 668-3988

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

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.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1528619319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504",
            "telephone_number": "919-684-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504",
            "telephone_number": "919-684-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISHAW",
        "first_name": "AMY",
        "middle_name": "MAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.