Individual provider Active NPI

Randi Morgan Glisson, MOT, OTR/L

  • Occupational Therapist
  • Lincolnton, NC
National Provider Identifier
1962223222
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17273 Issued in NC
Practice address
1244 N Flint St
Lincolnton, NC 28092-5239
Phone
(855) 983-0488
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 17273 NC Primary

Addresses

Primary practice location

1244 N Flint St
Lincolnton, NC 28092-5239

Mailing address

553 Saint Chrisnic CT
Mount Holly, NC 28120-9325
Phone (980) 396-8121

Other names 1

  • Ms. Randi Morgan Carver Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106002238 NC Practitioner - Occupational Therapist in Private Practice 8820522337 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17273NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kidology, Inc Occupational Therapist CurrentSince Oct 18, 2024 Accepting new patients

Locations

1244 N Flint St
Lincolnton, NC 28092
Phone (704) 740-0676

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1962223222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 SAINT CHRISNIC CT",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281209325",
            "telephone_number": "980-396-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N FLINT ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280925239",
            "telephone_number": "855-983-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "RANDI",
        "middle_name": "MORGAN",
        "name_prefix": "Mrs.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "17273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "CARVER",
            "middle_name": "MORGAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.