Active NPI
Tracey M Backus, OTR/L
- Occupational Therapist
- Matthews, NC
National Provider Identifier
1811281546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2495
- Practice address
- 10043 Idlewild Rd
Matthews, NC 28105-2013 - Phone
- (704) 545-0009
- NPI assigned
- May 28, 2011
- Last updated
- May 28, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2495 | NC | Primary |
Addresses
Primary practice location
10043 Idlewild Rd
Matthews, NC 28105-2013
Mailing address
10645 Stone Bunker Dr
Mint Hill, NC 28227-7036
Phone (704) 575-3765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
128 S Tryon St
Suite 1920
Charlotte, NC 28202-5001
Phone (877) 472-2261
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2495 | NC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services, Inc. | Occupational Therapist | Current | Accepting new patients |
| Reinvent Health Inc | Current | Accepting new patients | |
| Legacy Healthcare Services Inc | Occupational Therapist | Current | Accepting new patients |
| Prava PC | Occupational Therapist | Current | Accepting new patients |
Locations
2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Durham, NC
- NPI 1104823400
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306540800000",
"number": "1811281546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10645 STONE BUNKER DR",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282277036",
"telephone_number": "704-575-3765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10043 IDLEWILD RD",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281052013",
"telephone_number": "704-545-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKUS",
"first_name": "TRACEY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-28",
"last_updated": "2011-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "2495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.