Connie Beth Ammann, OTR/L

Individual provider Active NPI Occupational Therapist · Wilmington, NC

NPI 1992992317 · NPPES record last updated Jan 13, 2009

Key facts

NPI
1992992317
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3947 (NC)
Practice address
4557 Technology Dr
Suite 1
Wilmington, NC 28405-2171
Phone
(910) 233-0730
NPI assigned
Sep 30, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Care Therapy Incorporation (2 clinicians)

Practice addresses (Care Compare)

6626 Gordon Rd
Suite H
Wilmington, NC 28411-8424
Phone (910) 233-0730

Merit-based Incentive Payment System (MIPS)

Final score
81.58 of 100 (individual)
Quality
56.67
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20071228000373 NC Practitioner - Occupational Therapist in Private Practice 2769562941 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3947NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home Therapy Franchising, LLC Occupational Therapist Current
since Feb 2, 2020
Accepting new patients
Self Care Therapy Incorporation Occupational Therapist Current
since Oct 1, 2007
Accepting new patients
Cornerstone Services, Inc. Occupational Therapist Past Accepting new patients
Carolinas Cognitive Care, Inc. Occupational Therapist Past Accepting new patients

Locations

4557 Technology Dr
Ste 1
Wilmington, NC 28405
Phone (910) 233-0730

6626 Gordon Rd
Ste H
Wilmington, NC 28411
Phone (910) 233-0726

530 Causeway Dr
Ste B6
Wrightsville Beach, NC 28480
Phone (910) 509-2810

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3947 NC Yes

Addresses

Primary practice location

4557 Technology Dr
Suite 1
Wilmington, NC 28405-2171

Mailing address

6612 Dorrington Dr
Wilmington, NC 28412-3085
Phone (910) 793-8753

Other providers in Wilmington, NC

All providers in Wilmington, NC · Occupational Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.