Individual provider Active NPI

Elizabeth Nutt, COTA/L

  • Occupational Therapy Assistant
  • Siler City, NC
National Provider Identifier
1790225191
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
10704 Issued in NC
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

Updated by the provider on Mar 3, 2017

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 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

LicenseStateTypeSpecialty
10704NCMDOccupational 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.

Verify at the official NPI Registry.