Active NPI
Grant Michael Burleson
- Occupational Therapist
- Hickory, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 16664
- Practice address
- 214 18TH St SE
Hickory, NC 28602-1363 - Phone
- (828) 485-2160
- NPI assigned
- Apr 2, 2024
- Last updated
- Dec 16, 2024
- Sex
- Male
- 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 | 16664 | NC | Primary |
Addresses
Primary practice location
214 18TH St SE
Hickory, NC 28602-1363
Mailing address
4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-3611
Other practice location 1
214 18th St SE
Hickory, NC 28602-1363
Phone (828) 485-2160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16664 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthocarolina | Occupational Therapist | Current | Accepting new patients |
| Orthocarolina | Occupational Therapist | Current | Accepting new patients |
| Foundation Health Systems LLC | Occupational Therapist | Past | Accepting new patients |
Locations
1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000
4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090
214 18th St SE
Hickory, NC 28602
Phone (828) 322-5172
Organizations & group practices 3
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.
-
dba Novant Health Rehabilitation Center
- Physical Therapy Clinic/Center
- Winston Salem, NC
- NPI 1205894029
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1922850221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 18TH ST SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021363",
"telephone_number": "828-485-2160"
}
],
"practiceLocations": [
{
"address_1": "214 18th St SE",
"address_purpose": "LOCATION",
"city": "Hickory",
"state": "NC",
"postal_code": "286021363",
"country_code": "US",
"telephone_number": "828-485-2160",
"fax_number": "828-485-2161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURLESON",
"first_name": "GRANT",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-02",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "16664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.