Individual provider Active NPI

Michelle Willis, OTR/L

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1952762098
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1237 Issued in NC
Practice address
3311 Burnt Mill Dr
Wilmington, NC 28403-2654
Phone
(910) 251-5817
Fax
(910) 251-2652
NPI assigned
Mar 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1237 NC Primary

Addresses

Primary practice location

3311 Burnt Mill Dr
Wilmington, NC 28403-2654

Mailing address

3311 Burnt Mill Dr
Wilmington, NC 28403-2654
Phone (910) 251-5817

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

LicenseStateTypeSpecialty
1237NCMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1952762098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 BURNT MILL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032654",
            "telephone_number": "910-251-5817",
            "fax_number": "910-251-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BURNT MILL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032654",
            "telephone_number": "910-251-5817",
            "fax_number": "910-251-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHELLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "1237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.