Active NPI
Kerry Ann Macdonald, OTR
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1689164535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11738
- Practice address
- 2720 Holt St
Charlotte, NC 28205-1624 - Phone
- (734) 358-2177
- NPI assigned
- May 16, 2018
- Last updated
- Oct 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 11738 | NC | Primary |
Addresses
Primary practice location
2720 Holt St
Charlotte, NC 28205-1624
Mailing address
1147 Sibley St NW
Grand Rapids, MI 49504-5459
Phone (734) 358-2177
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11738 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1689164535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1147 SIBLEY ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045459",
"telephone_number": "734-358-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 HOLT ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282051624",
"telephone_number": "734-358-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "KERRY",
"middle_name": "ANN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-16",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11738",
"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 Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.