Individual provider Active NPI

Alisa Marie Durand, OTA

  • Occupational Therapy Assistant
  • Durham, NC
National Provider Identifier
1720509961
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
11124 Issued in NC
Practice address
300 Meredith Dr
Durham, NC 27713-2282
Phone
(919) 361-1234
NPI assigned
Jun 28, 2017
Last updated
Sep 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 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

LicenseStateTypeSpecialty
OTA13234FLMDOccupational Therapy Assistant
11124NCMDOccupational 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.

Verify at the official NPI Registry.