CARROLL FERNSTROM (NPI# 1588631279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588631279 |
| Entity Type | Individual |
| Full Name | CARROLL FERNSTROM |
| Credential | OT |
| Practice Address |
926 Williamson Dr Raleigh NC 27608-2308 |
| Practice Telephone | 9196966691 |
| Practice Fax Number | 9198466767 |
| Mailing Telephone | 9196966691 |
| Mailing Fax Number | 9198466767 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2013-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 0315 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE PTAN | 2510811-A | 01 |
| NC | BCBS | 1321M | 01 |
| NC | 7301597 | 05 | |
| NC | TAX ID | 562132986 | 01 |
| NC | RAILROAD | P00021102 | 01 |
| NC | MEDICARE PTAN | Q38337A | 01 |
| Street Address |
926 WILLIAMSON DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27608-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093781403 | Frank J Hielema | Physical Therapist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2006-02-24 |
| 1568742906 | Dawn M Mcloughlin | Speech-Language Pathologist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2011-08-17 |
| 1326127242 | Suresteps Inc | Physical Therapist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2006-11-02 |
| 1720036940 | Melissa Garrette Horton | Physical Therapist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2006-05-04 |
| 1275501462 | Nandita Garg | Occupational Therapist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2006-03-14 |
| 1669449328 | Rita B Atkins | Physical Therapist | 926 Williamson Dr, Raleigh, NC 27608-2308 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255856175 | Abbe Colodny Pllc | Community/Behavioral Health | 330 Pershing Road, Ralegih, NC 27608 | 2017-08-11 |
| 1417303975 | Restoration Family Counseling | Social Worker | 3103 Eton Rd, Raleigh, NC 27608 | 2016-05-13 |
| 1194192864 | Kathryn Bailey Jeutter | Specialist/Technologist | 1550 Iredell Dr, Raleigh, NC 27608 | 2015-08-28 |
| 1285950345 | Kathryn Dukes Miller | Social Worker | 2306 Mcmullan Circle, Raleigh, NC 27608 | 2010-04-14 |
| 1093043341 | Kristen Bryda Beach | Dietitian, Registered | 608 Scales Towne Court, Raleigh, NC 27608 | 2009-11-25 |
| 1811144942 | Rachael Hollister Wooten | Psychologist | 2721 Kittrell Dr., Raleigh, NC 27608 | 2008-08-20 |
| 1861641862 | Michele Carpenter Bulk | Physical Therapist | 513 E Whitaker Mill Rd, Raleigh, NC 27608 | 2008-09-15 |
| 1770872673 | Wendy Jill Phillips | Physical Therapist | 2626 Glennwood Ave, Suite 160, Raleigh, NC 27608-0000 | 2011-03-31 |
| 1427147875 | Brian J Kelleher Dds Pa | Clinic/Center | 2609 Glenwood Ave, Raleigh, NC 27608-1003 | 2006-10-12 |
| 1942795455 | Seth C Rumley Dds Pa II | Dentist | 2609 Glenwood Ave, Raleigh, NC 27608-1003 | 2018-06-27 |
| Find all providers in zip 27608 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548873037 | Christina Connors | Occupational Therapist | 10101 Ethridge Ct, Raleigh, NC 27615-1152 | 2020-08-25 |
| 1750907069 | Shelby Leanna Caulk | Occupational Therapist | 1001 Hillsborough St Apt 204, Raleigh, NC 27603-1556 | 2020-06-23 |
| 1558991083 | Kosmos LLC | Occupational Therapist | 12100 Peed Rd, Raleigh, NC 27614-9259 | 2020-01-23 |
| 1568018059 | Pt Solutions of North Carolina LLC | Occupational Therapist | 10940 Raven Ridge Rd Ste 110, Raleigh, NC 27614-6611 | 2019-08-12 |
| 1063979300 | Jaime Carlisle Fair | Occupational Therapist | 4834 Crockett Ct, Raleigh, NC 27606-6304 | 2019-02-22 |
| 1275008773 | Cassietta Harris | Occupational Therapist | 2505 Birchford Ct, Raleigh, NC 27604-8416 | 2018-10-10 |
| 1710470596 | Rachel Miller Hatchell | Occupational Therapist | 7401 Rolling Dale Ct, Raleigh, NC 27615-5811 | 2018-06-07 |
| 1518479963 | Kristina Marie Carreira | Occupational Therapist | 3803 Computer Dr Ste 200, Raleigh, NC 27609-6525 | 2017-10-25 |
| 1629589197 | Morgan Sawyer | Occupational Therapist | 319 Chapanoke Road Suite 101, Raleigh, NC 27699-2047 | 2017-10-23 |
| 1962952341 | Maggie Sullivan | Occupational Therapist | 1324 Princess Anne Rd, Raleigh, NC 27607-4750 | 2016-10-10 |
| Find all providers in RALEIGH | ||||
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| 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.