Individual provider Active NPI

Teresa M McClung, COTA

  • Occupational Therapy Assistant
  • Morehead City, NC
National Provider Identifier
1639363351
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3799 Issued in NC
Practice address
812 Shepard St
Morehead City, NC 28557-4250
Phone
(252) 726-8611
NPI assigned
Sep 6, 2007
Last updated
Sep 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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 3799 NC Primary

Addresses

Primary practice location

812 Shepard St
Morehead City, NC 28557-4250

Mailing address

2511 Front St
Unit 1
Beaufort, NC 28516-9328
Phone (252) 717-5808

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
3799NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1639363351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 FRONT ST",
            "address_2": "UNIT 1",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285169328",
            "telephone_number": "252-717-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 SHEPARD ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574250",
            "telephone_number": "252-726-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUNG",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "3799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.