Active NPI
Koral Flanagan
- Occupational Therapy Assistant
- Rock Hill, SC
National Provider Identifier
1730586090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3378
- Practice address
- 1330 India Hook Rd
Rock Hill, SC 29732-2412 - Phone
- (803) 328-5000
- NPI assigned
- Dec 1, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3378 | SC | Primary |
| Occupational Therapy Assistant | 224Z00000X | 9410 | NC | |
| Occupational Therapy Assistant | 224Z00000X | 005899 | NY |
Addresses
Primary practice location
1330 India Hook Rd
Rock Hill, SC 29732-2412
Mailing address
3108 Eastover Ridge Dr
Apt 818
Charlotte, NC 28211-1451
Phone (631) 338-1065
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 |
|---|---|---|---|
| 9410 | NC | MD | Occupational Therapy Assistant |
| 3378 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westminster Presbyterian Center, Inc. | 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.
-
- Skilled Nursing Facility
- Rock Hill, SC
- NPI 1568416915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1730586090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3108 EASTOVER RIDGE DR",
"address_2": "APT 818",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111451",
"telephone_number": "631-338-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 INDIA HOOK RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297322412",
"telephone_number": "803-328-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANAGAN",
"first_name": "KORAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3378",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "9410",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "005899",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.