Active NPI
Elizabeth Nutt, COTA/L
- Occupational Therapy Assistant
- Siler City, NC
National Provider Identifier
1790225191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 10704
- Practice address
- 260 Village Lake Rd
Siler City, NC 27344-1820 - Phone
- (919) 742-4052
- NPI assigned
- Mar 3, 2017
- 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 | 10704 | NC | Primary |
Addresses
Primary practice location
260 Village Lake Rd
Siler City, NC 27344-1820
Mailing address
808 Riverway LN
Knightdale, NC 27545-7608
Phone (601) 594-2746
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 |
|---|---|---|---|
| 10704 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1790225191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 RIVERWAY LN",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275457608",
"telephone_number": "601-594-2746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 VILLAGE LAKE RD",
"city": "SILER CITY",
"state": "NC",
"postal_code": "273441820",
"telephone_number": "919-742-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTT",
"first_name": "ELIZABETH",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-03",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "10704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Siler City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.