Active NPI
Alisa Marie Durand, OTA
- Occupational Therapy Assistant
- Durham, NC
National Provider Identifier
1720509961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 11124
- Practice address
- 300 Meredith Dr
Durham, NC 27713-2282 - Phone
- (919) 361-1234
- NPI assigned
- Jun 28, 2017
- Last updated
- Sep 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA13234 | FL | |
| Occupational Therapy Assistant | 224Z00000X | 11124 | NC | Primary |
Addresses
Primary practice location
300 Meredith Dr
Durham, NC 27713-2282
Mailing address
22 Twelve Oaks Dr
Willow Spring, NC 27592-8989
Phone (954) 802-1683
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 |
|---|---|---|---|
| OTA13234 | FL | MD | Occupational Therapy Assistant |
| 11124 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1720509961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TWELVE OAKS DR",
"city": "WILLOW SPRING",
"state": "NC",
"postal_code": "275928989",
"telephone_number": "954-802-1683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEREDITH DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277132282",
"telephone_number": "919-361-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURAND",
"first_name": "ALISA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA13234",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "11124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.