Active NPI
Sandra Lee Proctor, COTA
- Occupational Therapy Assistant
- Winston Salem, NC
National Provider Identifier
1891810016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4653
- Practice address
- 1250 Arbor Rd
Winston Salem, NC 27104-1106 - Phone
- (336) 724-7921
- NPI assigned
- Mar 20, 2007
- 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 Therapy Assistant | 224Z00000X | 4653 | NC | Primary |
Addresses
Primary practice location
1250 Arbor Rd
Winston Salem, NC 27104-1106
Mailing address
6052 Yeaton Glen Dr
Winston Salem, NC 27107-3700
Phone (336) 327-7097
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4653 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891810016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6052 YEATON GLEN DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271073700",
"telephone_number": "336-327-7097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 ARBOR RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271041106",
"telephone_number": "336-724-7921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "SANDRA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "4653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
- Bethany Hamilton Pritchett, COTA/L
- Private Diagnostic Clinic, PLLC
- Prizms Center for Mindbody Integration LLC
- Procare Home Health, LLC
- Kandice Appleby Proctor, MSW, RCSWI
- Professional Care Home Health
- Professional Care Home Health Servi
- Professional Care Home Health Services
- Professional Care Home Health Services
- Professional Care Home Health Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.