Individual provider Active NPI

McKenzie Rae Erne

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1679357263
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
15671 Issued in NC
Practice address
14025 Perugia Way Apt 208
Charlotte, NC 28273-7212
Phone
(330) 741-1069
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT012174 OH
Occupational Therapist 225X00000X 15671 NC Primary

Addresses

Primary practice location

14025 Perugia Way Apt 208
Charlotte, NC 28273-7212

Mailing address

724 W River Rd
Valley City, OH 44280-9303
Phone (330) 741-1069

Other practice location 1

724 W River Rd
Valley City, OH 44280-9303
Phone (330) 741-1069

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
15671NCMDOccupational Therapist
OT012174OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1679357263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 W RIVER RD",
            "city": "VALLEY CITY",
            "state": "OH",
            "postal_code": "442809303",
            "telephone_number": "330-741-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14025 PERUGIA WAY APT 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282737212",
            "telephone_number": "330-741-1069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 W River Rd",
            "address_purpose": "LOCATION",
            "city": "Valley City",
            "state": "OH",
            "postal_code": "442809303",
            "country_code": "US",
            "telephone_number": "330-741-1069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERNE",
        "first_name": "MCKENZIE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT012174",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "15671",
            "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 Aug 23, 2023; 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.