Individual provider Active NPI

Jenelle Nicole Mrugalski, OTD, OTR

  • Pediatric Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1881320034
Registry record updated Jul 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
15267 Issued in NC
Practice address
1140 Turnbridge Rd
Charlotte, NC 28226-5862
Phone
(919) 260-8438
NPI assigned
Jul 29, 2022
Last updated
Jul 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 15267 NC Primary
Pediatric Occupational Therapist 225XP0200X NU

Addresses

Primary practice location

1140 Turnbridge Rd
Charlotte, NC 28226-5862

Mailing address

1725 Back Bay CT Apt K
Charlotte, NC 28212-7547
Phone (704) 615-7738

Other practice location 1

3701 Kidd Ln
Charlotte, NC 28216-7739
Phone (704) 827-3788

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shining Hope Farms Past Accepting new patients
Shine Therapy LLC Pediatrics PastSince Jul 31, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753574400000",
    "number": "1881320034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 BACK BAY CT APT K",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282127547",
            "telephone_number": "704-615-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 TURNBRIDGE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265862",
            "telephone_number": "919-260-8438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3701 Kidd Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167739",
            "country_code": "US",
            "telephone_number": "704-827-3788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MRUGALSKI",
        "first_name": "JENELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2025-07-27",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "15267",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.