Active NPI
Anna Mortensen Harmon, OTR/L
- Pediatric Occupational Therapist
- Irmo, SC
National Provider Identifier
1780938340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 4034
- Practice address
- 1036 Kinley Rd Ste B
Irmo, SC 29063-9632 - Phone
- (803) 787-3033
- NPI assigned
- Nov 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 4034 | SC | Primary |
Addresses
Primary practice location
1036 Kinley Rd Ste B
Irmo, SC 29063-9632
Mailing address
1036 Kinley Rd Ste B
Irmo, SC 29063-9632
Phone (803) 787-3033
Other practice location 1
3620 Covenant Rd
Columbia, SC 29204-4216
Phone (803) 787-3033
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 |
|---|---|---|---|
| 4034 | SC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocket Pediatric Therapy, LLC | Pediatrics | Current | Accepting new patients |
Locations
1036 Kinley Rd
Ste B
Irmo, SC 29063
Phone (803) 787-3033
Organizations & group practices 1
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": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1780938340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1036 KINLEY RD STE B",
"city": "IRMO",
"state": "SC",
"postal_code": "290639632",
"telephone_number": "803-787-3033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 KINLEY RD STE B",
"city": "IRMO",
"state": "SC",
"postal_code": "290639632",
"telephone_number": "803-787-3033"
}
],
"practiceLocations": [
{
"address_1": "3620 Covenant Rd",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292044216",
"country_code": "US",
"telephone_number": "803-787-3033",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARMON",
"first_name": "ANNA",
"middle_name": "MORTENSEN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-05",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "SC",
"license": "4034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.