Active NPI
Kimberly Koop Pecora, MOT OTRL
- Occupational Therapist
- Dunn, NC
National Provider Identifier
1942398391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1027
- Practice address
- 1100 S Clinton Ave
Suite C
Dunn, NC 28334 - Phone
- (910) 892-0027
- Fax
- (910) 892-0029
- NPI assigned
- Oct 11, 2006
- 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 | 1027 | NC | Primary |
Addresses
Primary practice location
1100 S Clinton Ave
Suite C
Dunn, NC 28334
Mailing address
1100 S Clinton Ave
Suite C
Dunn, NC 28334
Phone (910) 892-0027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7211634 | Medicaid | NC |
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 |
|---|---|---|---|
| 1027 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Therapy Services Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Dunn, NC
- NPI 1457332264
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246233600000",
"number": "1942398391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S CLINTON AVE",
"address_2": "SUITE C",
"city": "DUNN",
"state": "NC",
"postal_code": "28334",
"telephone_number": "910-892-0027",
"fax_number": "910-892-0029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S CLINTON AVE",
"address_2": "SUITE C",
"city": "DUNN",
"state": "NC",
"postal_code": "28334",
"telephone_number": "910-892-0027",
"fax_number": "910-892-0029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECORA",
"first_name": "KIMBERLY",
"middle_name": "KOOP",
"name_prefix": "Mrs.",
"credential": "MOT OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2009-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "1027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211634",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dunn, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.