Broad River Rehab - Medicare Occupational Therapist in Charlotte, NC

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Broad River Rehab is a medicare enrolled "Occupational Therapist" provider in Charlotte, North Carolina. Their current practice location is 9120 Willow Ridge Rd, Charlotte, North Carolina. You can reach out to their office (for appointments etc.) via phone at (704) 275-5336.

Broad River Rehab is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Broad River Rehab is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1902317589.

Contact Information

Broad River Rehab
9120 Willow Ridge Rd,
Charlotte, NC 28210-8313
(704) 275-5336
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameBroad River Rehab
TypeFacility
SpecialityOccupational Therapist
Location9120 Willow Ridge Rd, Charlotte, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1902317589
  • Provider Enumeration Date: 10/23/2017
  • Last Update Date: 11/28/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3375801350
  • Enrollment ID: O20171220002681

Medical Identifiers

Medical identifiers for Broad River Rehab such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902317589NPI-NPPES
1902317589MedicaidNC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist (* (Not Available))Secondary
225X00000XOccupational Therapist (* (Not Available))Primary
235Z00000XSpeech-language Pathologist (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Broad River Rehab acts as a billing entity for following providers:
Provider NameMarcial Fidis
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1659582906
PECOS PAC ID: 3072576776
Enrollment ID: I20080805000115
Provider NameCarol A Tercyak
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1447489521
PECOS PAC ID: 3971659822
Enrollment ID: I20090918000221
Provider NameJennifer Soule
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1801121660
PECOS PAC ID: 9436297967
Enrollment ID: I20091103000612
Provider NameKaren M Stevens
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1477598456
PECOS PAC ID: 6002942968
Enrollment ID: I20100330000685
Provider NameChristopher Michael Johnson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1861800542
PECOS PAC ID: 2961726195
Enrollment ID: I20150117000132
Provider NameSandra Mabutas
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1215287636
PECOS PAC ID: 5294014833
Enrollment ID: I20161122001311
Provider NameAlexandra M Krause
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1689086100
PECOS PAC ID: 9537403100
Enrollment ID: I20181208000014
Provider NameHolly Connor Devore
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1902939796
PECOS PAC ID: 9335480169
Enrollment ID: I20190404001703
Provider NameBenjamin J Diehl
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1568028694
PECOS PAC ID: 4183951825
Enrollment ID: I20190805000020
Provider NameMary Garavaglia
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1730636754
PECOS PAC ID: 1153753215
Enrollment ID: I20191112002071
Provider NameRebecca L Eichner
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1538417993
PECOS PAC ID: 0345670717
Enrollment ID: I20200427001051
Provider NameJulie S Burris
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1891879102
PECOS PAC ID: 5698188944
Enrollment ID: I20210106001858
Provider NameSheri Futrell
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1396016804
PECOS PAC ID: 0749672038
Enrollment ID: I20220118002339
Provider NameKaitlyn Jean Rogers
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1659904068
PECOS PAC ID: 5991128126
Enrollment ID: I20220503000705
Provider NameShy'ann Frazier
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1407460355
PECOS PAC ID: 3375924681
Enrollment ID: I20220718003589
Provider NameStephenie Talbert Rice
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1306078548
PECOS PAC ID: 0345626735
Enrollment ID: I20221010000474
Provider NameBonnie Lynn Elsdon
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1972841849
PECOS PAC ID: 8628293487
Enrollment ID: I20221216001694
Provider NameAngela R Dargis
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1770956237
PECOS PAC ID: 7315317625
Enrollment ID: I20230103000877
Provider NameMadison Kate Walston
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1538882873
PECOS PAC ID: 3476924952
Enrollment ID: I20230119002568
Provider NameSarah E Richardson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1578238655
PECOS PAC ID: 1456723568
Enrollment ID: I20230217000667
Provider NameMarian Nell Easler
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1508525809
PECOS PAC ID: 2365806486
Enrollment ID: I20230907003648
Provider NamePaola Isaac Ibe Powell
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1609650621
PECOS PAC ID: 1355792375
Enrollment ID: I20240103004421
Provider NameJeremy S Skrtich
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1508520800
PECOS PAC ID: 6002254778
Enrollment ID: I20240402000041
Provider NameLeshea Barnette
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1730768771
PECOS PAC ID: 2567905482
Enrollment ID: I20240620001861
Provider NameNehali S Patel
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1922344605
PECOS PAC ID: 9436696663
Enrollment ID: I20240805003433
Provider NameAmie Thoburn Sides
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1013417799
PECOS PAC ID: 7618416389
Enrollment ID: I20240826002347
Provider NameCaitlin Kinsella
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1285159616
PECOS PAC ID: 5698214815
Enrollment ID: I20240830002620
Provider NameWayne Adrian. Harris
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1104634112
PECOS PAC ID: 0143744946
Enrollment ID: I20250414000681
Provider NameJordan Rosenberger
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1023407129
PECOS PAC ID: 3072878222
Enrollment ID: I20250618000055
Provider NameJessica Anne Browning
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1043618598
PECOS PAC ID: 2961980792
Enrollment ID: I20260202002461
Provider NameFelicia Robinson Moody
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1720171903
PECOS PAC ID: 1355829102
Enrollment ID: I20260202002963
Provider NameKathrina Muego
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1932876687
PECOS PAC ID: 6305324112
Enrollment ID: I20260203000896
Provider NameMorgan Lynn Hesse
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1841093887
PECOS PAC ID: 2567940299
Enrollment ID: I20260203001621
Provider NameKaren Patterson
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1326382839
PECOS PAC ID: 7416307269
Enrollment ID: I20260203002304
Provider NameMorgan Makenzie Rice
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1427948413
PECOS PAC ID: 7113405739
Enrollment ID: I20260203004098
Provider NameAngela Shew Elledge
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1073403077
PECOS PAC ID: 5698254001
Enrollment ID: I20260205004133
Provider NameJames Kipple
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1629333422
PECOS PAC ID: 6608355979
Enrollment ID: I20260206001882
Provider NameJulie Ann Szabo
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1093971137
PECOS PAC ID: 0840509642
Enrollment ID: I20260207000409
Provider NameAnna Lucas
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1720661366
PECOS PAC ID: 5890274146
Enrollment ID: I20260207000700
Provider NameAshley Chaber
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1013692755
PECOS PAC ID: 6608355854
Enrollment ID: I20260208000247
Provider NameLeela Thapa
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1720896335
PECOS PAC ID: 0840779096
Enrollment ID: I20260209000157
Provider NameLaura L Cole
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1619777125
PECOS PAC ID: 6507345733
Enrollment ID: I20260209002175
Provider NameKimberly Jerrom
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1639545825
PECOS PAC ID: 4486912961
Enrollment ID: I20260209002639
Provider NameMary Blake Avery
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1326806589
PECOS PAC ID: 3971082025
Enrollment ID: I20260209002820
Provider NameJennifer Higgins Eller
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1043508880
PECOS PAC ID: 2668951641
Enrollment ID: I20260210001514
Provider NamePaul Sabo
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1689036535
PECOS PAC ID: 9032452263
Enrollment ID: I20260211000423
Provider NameMae Keogh
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1235837972
PECOS PAC ID: 6103306899
Enrollment ID: I20260212002249
Provider NameKathleen Ann Baker
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1285231852
PECOS PAC ID: 5496235194
Enrollment ID: I20260212002508
Provider NameKelly King Cunningham
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1184402737
PECOS PAC ID: 5597245209
Enrollment ID: I20260212002857
Provider NameJulie Kiok Lay Wong
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1063010031
PECOS PAC ID: 5395155139
Enrollment ID: I20260214000756
Provider NameThoma Jolette Parker
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1841763794
PECOS PAC ID: 0345720728
Enrollment ID: I20260215000211
Provider NameNina Y Whitley
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1548494727
PECOS PAC ID: 2668952060
Enrollment ID: I20260216000774
Provider NameKatie Ginader
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1942564984
PECOS PAC ID: 0244710499
Enrollment ID: I20260217000781
Provider NameAireen Centeno Dela Pena
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1508258872
PECOS PAC ID: 0648750752
Enrollment ID: I20260217003089
Provider NameTamika Pegues
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1144503434
PECOS PAC ID: 5193162725
Enrollment ID: I20260220001202
Provider NameTaija Heath
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1124545843
PECOS PAC ID: 3577044163
Enrollment ID: I20260222000159
Provider NameCourtney Schnedler
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1023462132
PECOS PAC ID: 1052892437
Enrollment ID: I20260224002472
Provider NameHannah Osborne
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1740760255
PECOS PAC ID: 8729569140
Enrollment ID: I20260224003447
Provider NameDestini Hardy-stover
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1841571049
PECOS PAC ID: 1153802491
Enrollment ID: I20260224004280
Provider NameStephanie Chorost
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1275484628
PECOS PAC ID: 2860973138
Enrollment ID: I20260225000653
Provider NameTara Nicole Poe
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1720433436
PECOS PAC ID: 6204317522
Enrollment ID: I20260225002032
Provider NameEmily Greenwood
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1992115943
PECOS PAC ID: 7810487584
Enrollment ID: I20260227002718
Provider NameRebecca Sky Leonard
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1659101079
PECOS PAC ID: 2163904061
Enrollment ID: I20260227004091
Provider NameHeidi Elizabeth Mallett
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1023597879
PECOS PAC ID: 4385126283
Enrollment ID: I20260228000087
Provider NameNancy L Burns
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1629929195
PECOS PAC ID: 0840772406
Enrollment ID: I20260303003252
Provider NameKevin Tacheny
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1215114293
PECOS PAC ID: 7618459637
Enrollment ID: I20260306003542
Provider NameElizabeth Clayman
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1760742431
PECOS PAC ID: 7416104815
Enrollment ID: I20260314000141
Provider NameDanielle Ashley-deloatch Frierson
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1548517683
PECOS PAC ID: 9537643515
Enrollment ID: I20260318000734
Provider NameSarah Elizabeth Billman
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1275325508
PECOS PAC ID: 8325522386
Enrollment ID: I20260318002203
Provider NameGeorgia Finch Westbrook
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1073218608
PECOS PAC ID: 7719461409
Enrollment ID: I20260320000415
Provider NameJennifer Stone
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1710181847
PECOS PAC ID: 8527542133
Enrollment ID: I20260323000251
Provider NameRoger William Stotler
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1215599279
PECOS PAC ID: 2567947179
Enrollment ID: I20260401001425
Provider NameTimothy Grey Wilson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1285897595
PECOS PAC ID: 3678048725
Enrollment ID: I20260407001667
Provider NameDanielle Janiece Secrest
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1679035075
PECOS PAC ID: 6507238458
Enrollment ID: I20260408001534

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Broad River Rehab is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Broad River Rehab
1 Pond St,
Arden, NC 28704-8500

Ph: (828) 774-5222		Broad River Rehab
9120 Willow Ridge Rd,
Charlotte, NC 28210-8313

Ph: (704) 275-5336

Reviews and Comments


Occupational Therapist in Charlotte, NC

Brenda Kennell, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 5100 Sharon Rd, Charlotte, NC 28210
Phone: 704-554-4818    Fax: 704-551-0659
Meghan Suntich, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 10648 Park Rd, Charlotte, NC 28210
Phone: 704-667-8200    
Carissa Eichler, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 326 S Bruns Ave, Charlotte, NC 28208
Phone: 704-910-7843    
Elisabeth Neely Theodossiou, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1100 Blythe Blvd, Charlotte, NC 28203
Phone: 704-355-4370    
Megan Marie Barber, OT
Occupational Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 13600 S Tryon St, Charlotte, NC 28278
Phone: 704-705-2727    
Madison Taylor O'hara, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 7926 Turquoise Dr, Charlotte, NC 28215
Phone: 704-816-9982    
Sarah S Sangermano, OT
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1100 Blythe Blvd, Charlotte, NC 28203
Phone: 704-355-4461    Fax: 704-355-4231

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.