Active NPI
Michelle Renae Stotesberry
- Occupational Therapy Assistant
- Swanquarter, NC
National Provider Identifier
1740841881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 12086
- Practice address
- 209 Main St
Swanquarter, NC 27885-9700 - Phone
- (252) 945-1523
- NPI assigned
- Jun 27, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 12086 | NC | Primary |
Addresses
Primary practice location
209 Main St
Swanquarter, NC 27885-9700
Mailing address
1719 Quarter Rd
Swanquarter, NC 27885-9616
Phone (252) 926-2143
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 |
|---|---|---|---|
| 12086 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1740841881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 QUARTER RD",
"city": "SWANQUARTER",
"state": "NC",
"postal_code": "278859616",
"telephone_number": "252-926-2143",
"fax_number": "252-926-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 MAIN ST",
"city": "SWANQUARTER",
"state": "NC",
"postal_code": "278859700",
"telephone_number": "252-945-1523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOTESBERRY",
"first_name": "MICHELLE",
"middle_name": "RENAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "12086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Swanquarter, NC
- Liberty Healthcare Group LLC (Cross Creek Health Care)
- Liberty Healthcare Group, LLC (Liberty Home Care VII, LLC)
- Liberty Healthcare Group, LLC (Liberty Home Care VII, LLC)
- Amber Simmons McCann, RN, BSN, IBCLC
- Irene Viola Pelliccia
- Tideland Mental Health Center- Swan Quarter Office
- Angela Williams-Crets, RD
- Emma Cahoon Williams, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.