Cool Beans Therapy Clubhouse, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

COOL BEANS THERAPY CLUBHOUSE, LLC

Practice address

17111 Kenton Dr Ste 206B
Cornelius, NC 28031-5650

Phone

(704) 237-4105

Fax

(704) 237-4107

NPI assigned

Apr 23, 2020

Organization subpart

No

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

Authorized official

Name

Erin R Crome, MOT, OTR/LNPI 1578692943

Title

Owner, Occupational Therapist

Phone

(704) 237-4105

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin Renae Crome, MOT, OTR/L

  • Pediatric Occupational Therapist
  • Cornelius, NC
  • NPI 1578692943

  Pediatrics

  NPD Authorized official
• Loren Kline, COTA/L

  • Occupational Therapy Assistant
  • Cornelius, NC
  • NPI 1720664501
  NPD

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1801416565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17111 KENTON DR STE 206B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315650",
            "telephone_number": "704-237-4105",
            "fax_number": "704-237-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17111 KENTON DR STE 206B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315650",
            "telephone_number": "704-237-4105",
            "fax_number": "704-237-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOL BEANS THERAPY CLUBHOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "CROME",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER, OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "704-237-4105",
        "authorized_official_credential": "MOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ecrome@coolbeanstherapyclubhouse.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17830 Statesville Rd Ste 205",
            "city": "Cornelius",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280319173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Occupational Therapist in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Pediatric Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.