Neurogenesis Therapy

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

Legal business name

NEUROGENESIS THERAPY

Practice address

4104 Hampton Park Way
Fuquay Varina, NC 27526-5475

Phone

(703) 980-6021

NPI assigned

Jul 11, 2021

Last updated

Jul 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Annmarie Dora Quilty, OTR/L

Title

Occupational Therapist

Phone

(703) 980-6021

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625961600000",
    "number": "1871165878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 HAMPTON PARK WAY",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275265475",
            "telephone_number": "703-980-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 HAMPTON PARK WAY",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275265475",
            "telephone_number": "703-980-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROGENESIS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-11",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A",
        "authorized_official_last_name": "QUILTY",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_middle_name": "DORA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "703-980-6021",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Marie Nantz, RN, AGNP-C
• Kristen Marie Nawyn, AGNP-C
• Ami Nayak
• Hannah Nealey, NP
• Kristal Kay Nelson, PT
• New Beginning Healthcare
• New Era of NC Inc (New Era Home Healthcare & Companion)
• Alexander Van Tam Nguyen, DO
• Kristina Nguyen
• Nichols Family Chiropractic PLLC

• Neurorehabilitation Occupational Therapist in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Neurorehabilitation Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.