Active NPI
Heidi Elenbaas, MS, OTR/L
- Occupational Therapist
- Fuquay Varina, NC
National Provider Identifier
1831696434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11525
- Practice address
- 410 S Judd Pkwy SE
Fuquay Varina, NC 27526-6953 - Phone
- (321) 848-7521
- NPI assigned
- Apr 10, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT14918 | FL | |
| Occupational Therapist | 225X00000X | 11525 | NC | Primary |
Addresses
Primary practice location
410 S Judd Pkwy SE
Fuquay Varina, NC 27526-6953
Mailing address
410 S Judd Pkwy SE
Fuquay Varina, NC 27526-6953
Phone (919) 577-0421
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT14918 | FL | MD | Occupational Therapist |
| 11525 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1831696434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 S JUDD PKWY SE",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275266953",
"telephone_number": "919-577-0421",
"fax_number": "919-557-3683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 S JUDD PKWY SE",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275266953",
"telephone_number": "321-848-7521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELENBAAS",
"first_name": "HEIDI",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-10",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT14918",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.