Individual provider Active NPI

Deborah Craig

  • Occupational Therapy Assistant
  • Myrtle Beach, SC
National Provider Identifier
1720322233
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3565 Issued in SC
Practice address
101 Brightwater Dr
Myrtle Beach, SC 29579-8275
Phone
(843) 903-8958
NPI assigned
Nov 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3565 SC Primary
Occupational Therapy Assistant 224Z00000X A01351 MD

Addresses

Primary practice location

101 Brightwater Dr
Myrtle Beach, SC 29579-8275

Mailing address

112 Cypress Point CT Unit 103
Myrtle Beach, SC 29579-6623
Phone (410) 459-5845

Other practice location 1

1881 Telegraph Rd
Rising Sun, MD 21911-2018
Phone (410) 658-6555

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
A01351MDMDOccupational Therapy Assistant
3565SCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720322233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CYPRESS POINT CT UNIT 103",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796623",
            "telephone_number": "410-459-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRIGHTWATER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295798275",
            "telephone_number": "843-903-8958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1881 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Rising Sun",
            "state": "MD",
            "postal_code": "219112018",
            "country_code": "US",
            "telephone_number": "410-658-6555",
            "fax_number": "410-658-9717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "3565",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A01351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.