Independence Rehabilitation Services Inc.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1237 Issued in NC

Legal business name

INDEPENDENCE REHABILITATION SERVICES INC.

Practice address

3109 Wickford Dr
Wilmington, NC 28409-8531

Phone

(910) 790-2869

NPI assigned

Feb 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Willis

Title

President

Phone

(910) 297-6067

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679613434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 WICKFORD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284098531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 WICKFORD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284098531",
            "telephone_number": "910-790-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE REHABILITATION SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-297-6067"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "1237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301005",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Wilmington, NC
• Providers in Wilmington, 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 Aug 22, 2020; 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.