Individual provider Active NPI

Penny Dawn-Hurst Houser, COTA/L

  • Occupational Therapy Assistant
  • Charlotte, NC
National Provider Identifier
1568755569
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2623 Issued in NC
Practice address
5101 Prosperity Church Rd
Charlotte, NC 28269-8732
Phone
(704) 510-0215
NPI assigned
May 24, 2011
Last updated
May 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2623 NC Primary

Addresses

Primary practice location

5101 Prosperity Church Rd
Charlotte, NC 28269-8732

Mailing address

2015 Applegate Dr
Concord, NC 28027-9673
Phone (704) 467-3442

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

LicenseStateTypeSpecialty
2623NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1568755569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 APPLEGATE DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280279673",
            "telephone_number": "704-467-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 PROSPERITY CHURCH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282698732",
            "telephone_number": "704-510-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSER",
        "first_name": "PENNY",
        "middle_name": "DAWN-HURST",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "2623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.