Individual provider Active NPI

Elizabeth Heider, OTD,OTR/L

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1639713761
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16488 Issued in NC
Practice address
4012 Park Rd
Charlotte, NC 28209-2377
Phone
(704) 332-4834
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 16488 NC Primary

Addresses

Primary practice location

4012 Park Rd
Charlotte, NC 28209-2377

Mailing address

4012 Park Rd
Charlotte, NC 28209-2377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102003546 GA Practitioner - Occupational Therapist in Private Practice 2668849704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16488NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Swallowing Diagnostics CurrentSince Oct 17, 2022 Accepting new patients
Theraplay, LLC PastSince Nov 17, 2019 Accepting new patients

Organizations & group practices 2

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": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1639713761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092377",
            "telephone_number": "704-332-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDER",
        "first_name": "ELIZABETH",
        "credential": "OTD,OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16488",
            "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 Apr 16, 2026; 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.