Grace Slack, OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6575 Issued in NC

Practice address

10508 Park Rd
Suite 130
Charlotte, NC 28210-8525

Phone

(704) 541-9080

Fax

(704) 542-0699

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1588781876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 LAKE WYLIE RD",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297109181",
            "telephone_number": "803-412-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10508 PARK RD",
            "address_2": "SUITE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108525",
            "telephone_number": "704-541-9080",
            "fax_number": "704-542-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3233",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "6575",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Skumpija
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• Amber C Slade
• Shykela Slade, FNP
• Tedra Marchette Slade, MSW, LCSW
• Lawrence Alexander Sladek, DDS
• Sladjana Bjelac DDS PLLC

• Pediatric Occupational Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.