Individual provider Active NPI

Robert Per William Erkstam, OTR

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1740395136
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4588 Issued in NC
Practice address
6626 Gordon Rd Ste H
Wilmington, NC 28411
Phone
(910) 798-4051
Fax
(910) 338-0424
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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 4588 NC Primary

Addresses

Primary practice location

6626 Gordon Rd Ste H
Wilmington, NC 28411

Mailing address

6626 Gordon Rd Ste H
Wilmington, NC 28411-8424
Phone (910) 233-0730

Other practice location 1

4557 Technology Dr
Suite 1
Wilmington, NC 28405-2171
Phone (910) 233-0730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213000091 NC Practitioner - Occupational Therapist in Private Practice 8921065988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Care Therapy IncorporationGroup PAC ID 3375546864, 2 clinicians

Practice addresses (Care Compare)

6626 Gordon Rd
Suite H
Wilmington, NC 28411-8424
Phone (910) 233-0730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4588NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Self Care Therapy Incorporation Occupational Therapist CurrentSince May 1, 2006 Accepting new patients
At Home Therapy Franchising, LLC Occupational Therapist PastSince Feb 2, 2020 Accepting new patients
Carolina Therapy Services Inc Occupational Therapist Past Accepting new patients
At Home Therapy of Wilmington, Inc. Occupational Therapist PastSince Oct 1, 2004 Accepting new patients

Locations

4557 Technology Dr
Ste 1
Wilmington, NC 28405
Phone (910) 233-0730

6626 Gordon Rd
Ste H
Wilmington, NC 28411
Phone (910) 233-0726

Organizations & group practices 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1740395136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 GORDON RD STE H",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118424",
            "telephone_number": "910-233-0730",
            "fax_number": "910-338-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 GORDON RD STE H",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28411",
            "telephone_number": "910-798-4051",
            "fax_number": "910-338-0424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4557 Technology Dr",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284052171",
            "country_code": "US",
            "telephone_number": "910-233-0730",
            "fax_number": "910-338-0424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERKSTAM",
        "first_name": "ROBERT",
        "middle_name": "PER WILLIAM",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "4588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.