Individual provider Active NPI

Angela Fenelon, OTR/L

  • Occupational Therapist
  • New Bern, NC
National Provider Identifier
1730580473
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9367 Issued in NC
Practice address
3303 US Highway 70 E
New Bern, NC 28560-6929
Phone
(252) 672-8680
Fax
(252) 637-4812
NPI assigned
Sep 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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 9367 NC Primary

Addresses

Primary practice location

3303 US Highway 70 E
New Bern, NC 28560-6929

Mailing address

3303 US Highway 70 E
New Bern, NC 28560-6929
Phone (252) 672-8680

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
9367NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
OT Kidz PLLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1730580473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 US HIGHWAY 70 E",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285606929",
            "telephone_number": "252-672-8680",
            "fax_number": "252-637-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 US HIGHWAY 70 E",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285606929",
            "telephone_number": "252-672-8680",
            "fax_number": "252-637-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENELON",
        "first_name": "ANGELA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "9367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.