Active NPI
Joseph Mathis
- Occupational Therapist
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 15556
- Practice address
- 170 Kimel Park Dr
Winston Salem, NC 27103-6946 - Phone
- (336) 765-7058
- NPI assigned
- Dec 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15556 | NC | Primary |
Addresses
Primary practice location
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Mailing address
4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-3611
Other practice location 1
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 765-7058
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0397730042 | Other | NC | NSC# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2718 Henry St
Greensboro, NC 27405-3633
Phone (336) 375-1007
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15556 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthocarolina | Occupational Therapist | Current | Accepting new patients |
| Wake Forest University Health Sciences | Occupational Therapist | Current | Accepting new patients |
| Orthocarolina | Occupational Therapist | Current | Accepting new patients |
Locations
4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090
1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000
2718 Henry St
Greensboro, NC 27405
Phone (336) 375-1007
861 Old Winston Rd
Kernersville, NC 27284
Phone (336) 713-3500
170 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 765-7058
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1639882053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 KIMEL PARK DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036946",
"telephone_number": "336-765-7058"
}
],
"practiceLocations": [
{
"address_1": "170 Kimel Park Dr",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271036946",
"country_code": "US",
"telephone_number": "336-765-7058",
"fax_number": "336-346-2152",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHIS",
"first_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-30",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "15556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NSC#",
"identifier": "0397730042",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.