Individual provider Active NPI

Regina Mae Lefauve, OTR/L

  • Occupational Therapist
  • Cornelius, NC
National Provider Identifier
1689658916
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5366 Issued in NC
Practice address
19772 One Norman Blvd
Cornelius, NC 28031
Phone
(980) 306-5300
NPI assigned
Nov 30, 2005
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5366 NC Primary

Addresses

Primary practice location

19772 One Norman Blvd
Cornelius, NC 28031

Mailing address

514 Williamson Rd
Suite 431
Mooresville, NC 28117-9225
Phone (704) 641-4461

Other practice location 1

514 Williamson Rd
Suite 431
Mooresville, NC 28117-9225
Phone (704) 641-4461

Other practice location 2

1035 Lincolnton Rd Ste A
Salisbury, NC 28144-6260
Phone (704) 603-1352

Other identifiers 4

IdentifierTypeStateIssuer
2414673OtherUNITED HEALTHCARE
D8766OtherMEDCOST
7379530OtherAETNA
1372TOtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000699 NC Practitioner - Occupational Therapist in Private Practice 8426015785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5366NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC CurrentSince Sep 6, 2022 Accepting new patients
Ivyrehab North Carolina LLC Hand CurrentSince Sep 6, 2022 Accepting new patients
Northeast Orthopedics PA Occupational Therapist Past Accepting new patients

Locations

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Interoperability endpoints

  • Direct secure messaging: rlefauve1150326@direct.novanthealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1689658916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 WILLIAMSON RD",
            "address_2": "SUITE 431",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179225",
            "telephone_number": "704-641-4461",
            "fax_number": "704-896-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19772 ONE NORMAN BLVD",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031",
            "telephone_number": "980-306-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Williamson Rd",
            "address_2": "Suite 431",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179225",
            "country_code": "US",
            "telephone_number": "704-641-4461",
            "fax_number": "704-896-2686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Lincolnton Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281446260",
            "country_code": "US",
            "telephone_number": "704-603-1352",
            "fax_number": "704-603-1392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEFAUVE",
        "first_name": "REGINA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2414673",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D8766",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7379530",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1372T",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.