Active NPI
Monica Lynn Brouillette, MS, OTR/L
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1780088286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9422
- Practice address
- 4603 Waterford Knoll Dr
Apt 1834
Charlotte, NC 28226-7084 - Phone
- (570) 983-9174
- NPI assigned
- Oct 14, 2014
- Last updated
- Jan 3, 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 Therapist | 225X00000X | 9422 | NC | Primary |
Addresses
Primary practice location
4603 Waterford Knoll Dr
Apt 1834
Charlotte, NC 28226-7084
Mailing address
2006 Chapman St
Indian Trail, NC 28079-0168
Phone (570) 983-9174
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9422 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546473600000",
"number": "1780088286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2006 CHAPMAN ST",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280790168",
"telephone_number": "570-983-9174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4603 WATERFORD KNOLL DR",
"address_2": "APT 1834",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282267084",
"telephone_number": "570-983-9174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUILLETTE",
"first_name": "MONICA",
"middle_name": "LYNN",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-14",
"last_updated": "2019-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "9422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.