Active NPI
Alyssa Speake, MOT, OTR/L
- Occupational Therapist
- Fountain Inn, SC
National Provider Identifier
1912520255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5830
- Practice address
- 204 Shady Pines CT
Fountain Inn, SC 29644-9785 - Phone
- (864) 399-9785
- NPI assigned
- May 21, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5830 | SC | Primary |
Addresses
Primary practice location
204 Shady Pines CT
Fountain Inn, SC 29644-9785
Mailing address
104 Seven Oaks Dr
Seneca, SC 29678-6034
Phone (678) 787-4669
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 |
|---|---|---|---|
| 5830 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1912520255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 SEVEN OAKS DR",
"city": "SENECA",
"state": "SC",
"postal_code": "296786034",
"telephone_number": "678-787-4669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 SHADY PINES CT",
"city": "FOUNTAIN INN",
"state": "SC",
"postal_code": "296449785",
"telephone_number": "864-399-9785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAKE",
"first_name": "ALYSSA",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-21",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "5830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Inn, SC
- Keri Skipper, SLP
- Solutions in Transportation LLC
- South Carolina CVS Pharmacy LLC (CVS Pharmacy #05542)
- South Carolina Department of Juvenile Justice
- South Carolina Department of Juvenile Justice
- Kelly Jordan Spence, MD
- Shelby Elise Spicer, MD
- Stat Home Care
- David Stoddard
- Sudduth Management Group LLC (Pioneer Family Dentistry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.