Individual provider Active NPI

Caryn Fidalgo, OT

  • Occupational Therapist
  • Monroe, NC
National Provider Identifier
1720538218
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
10415 Issued in NC
Practice address
1002 Unity CT
Monroe, NC 28110-7878
Phone
(704) 283-0028
NPI assigned
Oct 7, 2016
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10415 NC Primary

Addresses

Primary practice location

1002 Unity CT
Monroe, NC 28110-7878

Mailing address

8920 Pennegrove Cir
Charlotte, NC 28214-8138
Phone (813) 846-4019

Other identifiers 1

IdentifierTypeStateIssuer
72-0132BMedicaidNC

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
10415NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Without Barriers LLC CurrentSince Oct 20, 2024 Accepting new patients
Full Circle Pediatric Therapy Occupational Therapist CurrentSince Oct 20, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1720538218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 PENNEGROVE CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282148138",
            "telephone_number": "813-846-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 UNITY CT",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281107878",
            "telephone_number": "704-283-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDALGO",
        "first_name": "CARYN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "10415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72-0132B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.