Individual provider Active NPI

Caitlin Moore Sund, MHS OTRL

  • Pediatric Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1700855434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
5695 Issued in NC
Practice address
10508 Park Rd
Suite 130
Charlotte, NC 28210-8405
Phone
(704) 541-9080
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 5695 NC Primary
Pediatric Occupational Therapist 225XP0200X 11281 FL

Addresses

Primary practice location

10508 Park Rd
Suite 130
Charlotte, NC 28210-8405

Mailing address

3105 Well House CT
Charlotte, NC 28210-7932
Phone (704) 541-9080

Other identifiers 1

IdentifierTypeStateIssuer
7301803MedicaidNC

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
11281FLMDPediatric Occupational Therapist
5695NCMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700855434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 WELL HOUSE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282107932",
            "telephone_number": "704-541-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10508 PARK RD",
            "address_2": "SUITE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108405",
            "telephone_number": "704-541-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUND",
        "first_name": "CAITLIN",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "MHS OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "5695",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "11281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301803",
            "state": "NC"
        }
    ],
    "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 Jul 8, 2007; 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.