Active NPI
Reba Renee Hartlage, OTD, OTR/L, CLT
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1932702420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13662
- Practice address
- 1100 Blythe Blvd
Charlotte, NC 28203-5814 - Phone
- (704) 446-4335
- NPI assigned
- Nov 18, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT.6010 | SC | |
| Occupational Therapist | 225X00000X | 13662 | NC | Primary |
Addresses
Primary practice location
1100 Blythe Blvd
Charlotte, NC 28203-5814
Mailing address
374 Counselors Way Apt 303
Fort Mill, SC 29708-8648
Phone (249) 922-8907
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13662 | NC | MD | Dentist |
| OT.6010 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1932702420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "374 COUNSELORS WAY APT 303",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297088648",
"telephone_number": "249-922-8907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035814",
"telephone_number": "704-446-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTLAGE",
"first_name": "REBA",
"middle_name": "RENEE",
"credential": "OTD, OTR/L, CLT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "OT.6010",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "13662",
"primary": true
}
],
"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 Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.