Active NPI
Amy Dominica Secret
- Occupational Therapist
- Spruce Pine, NC
National Provider Identifier
1912212614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4054
- Practice address
- 218 Laurel Creek CT
Spruce Pine, NC 28777-3134 - Phone
- (828) 765-7312
- NPI assigned
- Aug 18, 2010
- 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 | 4054 | NC | Primary |
Addresses
Primary practice location
218 Laurel Creek CT
Spruce Pine, NC 28777-3134
Mailing address
600 Ridge Rd
Blairsville, GA 30512-3923
Phone (828) 333-1558
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1912212614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 RIDGE RD",
"city": "BLAIRSVILLE",
"state": "GA",
"postal_code": "305123923",
"telephone_number": "828-333-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 LAUREL CREEK CT",
"city": "SPRUCE PINE",
"state": "NC",
"postal_code": "287773134",
"telephone_number": "828-765-7312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SECRET",
"first_name": "AMY",
"middle_name": "DOMINICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-18",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "4054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spruce Pine, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.