Andrea Tivoli, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

15809 Issued in NC

Practice address

87462 Edsen CT
Lancaster, SC 29720-6433

Phone

(910) 263-6139

NPI assigned

Sep 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Durham, NC
  • NPI 1104823400

  Occupational Therapist

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730592000000",
    "number": "1700611761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87462 EDSEN CT",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297206433",
            "telephone_number": "910-263-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87462 EDSEN CT",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297206433",
            "telephone_number": "910-263-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIVOLI",
        "first_name": "ANDREA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-11-03",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6779",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "15809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Wellness LLC
• Demarcus Antonio Thompson
• Janay Thompson
• Douglas L. Tiedt, MD
• Amanda Tilstra
• Sibonokuhle Tizora, M.D
• Patrick Donahue Tolbert, SAS
• Tracey Karen Buama Topacio, D.O.
• Margaret Townsend, R.N.
• Richard E Townsend, MD

• Occupational Therapist in Lancaster, SC
• Providers in Lancaster, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; 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.