PRIME OCCUPATIONAL THERAPY PLLC (NPI# 1780036988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780036988 |
| Entity Type | Organization |
| Organization Name | PRIME OCCUPATIONAL THERAPY PLLC |
| Practice Address |
1004 Peony Ct Knightdale NC 27545-7051 |
| Practice Telephone | 9195398661 |
| Practice Fax Number | 9193739564 |
| Mailing Telephone | 9195398661 |
| Mailing Fax Number | 9193739564 |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |
| Authorized Official Name | MRS. MAHTSENTE WORKU EBRON (OCCUPATIONAL THERAPIST) |
| Authorized Official Telephone | 9195398661 |
| Authorized Official Credential | MSHS OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 4262 | NC | Residential Treatment Facilities |
| Street Address |
1004 PEONY CT |
| City | KNIGHTDALE |
| State | NC |
| Zip Code | 27545-7051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417155177 | Mahtsente Worku Ebron | Occupational Therapist | 1004 Peony Ct, Knightdale, NC 27545-7051 | 2007-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688526 | Galberth Health | Physical Therapist | 8002 Peachtree Town Ln, Knightdale, NC 27545 | 2017-09-24 |
| 1790215390 | Edward Hoggard Jr. | Counselor | 2013 Ballston Place, Knightdale, NC 27545 | 2017-06-15 |
| 1730635970 | Tara Forsythe | Social Worker | 4006 Peachtree Town Lane, Knightdale, NC 27545 | 2016-08-28 |
| 1134504962 | Maybell Grino | Pharmacist | 7201 Us Highway 64, Knightdale, NC 27545 | 2015-07-22 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1235560772 | Shameka Latoya Davis | Counselor | 7417 Knightdale Blvd Unit 101, Knightdale, NC 27545 | 2013-12-10 |
| 1992135107 | Daniel Ross Conti | Dentist | 1001 Widewaters Parkway, Knightdale, NC 27545 | 2013-11-25 |
| 1255773644 | David D Sanjurjo | Nurse Practitioner | 7201 Us Hwy 64, Knightdale, NC 27545 | 2013-07-25 |
| 1790037133 | Dona D Mayo | Counselor | 502 Mcknight Drive, Better Communities, Knightdale, NC 27545 | 2012-10-09 |
| 1699972257 | Lindsay Horwat | Occupational Therapist | 1010 Emerald Common Drive, Apartment 205, Knightdale, NC 27545 | 2007-06-28 |
| Find all providers in zip 27545 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883170 | Vision of Therapeutic Development, Inc. | Residential Treatment Facility, Physical Disabilities | 35 Southern Village Dr, Roxboro, NC 27573-2516 | 2019-10-24 |
| 1144760844 | Tjt Family Home | Residential Treatment Facility, Physical Disabilities | 116 Leanne Dr, Greenville, NC 27858-8126 | 2017-02-28 |
| 1104361518 | Senior Care Carolinas | Residential Treatment Facility, Physical Disabilities | 9640 Gilead Grove Rd, Huntersville, NC 28078-2289 | 2016-12-21 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1417329749 | Troy Leigh Lockamy | Residential Treatment Facility, Physical Disabilities | 300 Meredith Dr, Durham, NC 27713-2282 | 2015-10-26 |
| 1689044638 | April Campbell Lee | Residential Treatment Facility, Physical Disabilities | 3204 Huntleigh Dr, Raleigh, NC 27604-3310 | 2015-10-03 |
| 1538545025 | Viktoriya Semenova | Residential Treatment Facility, Physical Disabilities | 1405 Falls Church Rd, Raleigh, NC 27609-4015 | 2015-08-06 |
| 1356744932 | Z & M Residential Villa 1 | Residential Treatment Facility, Physical Disabilities | 10298 Pasture Rd, Middlesex, NC 27557-7200 | 2014-09-26 |
| 1841608866 | Noa Human Services LLC 3 | Residential Treatment Facility, Physical Disabilities | 1847 Waycross Drive, Winston Salem, NC 27106 | 2014-07-23 |
| 1831527233 | Audrey F Jessup | Residential Treatment Facility, Physical Disabilities | 1471 Deer Rd, Mt Airy, NC 27030-1471 | 2013-10-22 |
| Find all providers with the same taxonomy | ||||
| City | KNIGHTDALE |
| Zip Code | 27545 |
Please comment or provide details below to improve the information on PRIME OCCUPATIONAL THERAPY PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.