Mary Ravenel Anderson, OTLR
Individual provider Active NPI Occupational Therapist · Charleston, SC
NPI 1740230283 · NPPES record last updated Oct 4, 2007
Key facts
- NPI
- 1740230283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 1941 Savage Road
Ste 300a
Charleston, SC 29407 - Phone
- (843) 402-1495
- Fax
- (843) 402-1285
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Centers of Charleston, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Yes |
Addresses
Primary practice location
1941 Savage Road
Ste 300a
Charleston, SC 29407
Mailing address
586 Lone Tree Dr
Mt Pleasant, SC 29464
Phone (843) 402-1495
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP1753 | Medicaid | SC | |
| TH0691 | Medicaid | SC |
Other providers in Charleston, SC
- Kelly Margaret Anderson
- Kristin Nicole Anderson
- Kristy Carter Anderson
- Mara Anderson
- Marlo Anderson
- Matthew Patrick Anderson
- Melanie Sue Anderson
- Michael B Anderson
- Paige Anderson
- Paul David Anderson
All providers in Charleston, SC · Occupational Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.