Individual provider Active NPI

Percy Gratuito Alvarado

  • Occupational Therapy Assistant
  • Summerville, SC
National Provider Identifier
1770307167
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2610 Issued in SC
Practice address
5130 Wescott Blvd
Summerville, SC 29485-9043
Phone
(843) 486-2712
Fax
(843) 879-9808
NPI assigned
Nov 12, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2610 SC Primary

Addresses

Primary practice location

5130 Wescott Blvd
Summerville, SC 29485-9043

Mailing address

362 Old Grade Rd
Moncks Corner, SC 29461-9491
Phone (843) 460-7870

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
2610SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1770307167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 OLD GRADE RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294619491",
            "telephone_number": "843-460-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 WESCOTT BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294859043",
            "telephone_number": "843-486-2712",
            "fax_number": "843-879-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVARADO",
        "first_name": "PERCY",
        "middle_name": "GRATUITO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.