Healthcare Provider Details

I. General information

NPI: 1801118450
Provider Name (Legal Business Name): JOHN M FIELDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 05/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 NUWAY CIR
LENOIR NC
28645-3656
US

IV. Provider business mailing address

4146 CHERRYWOOD DR APT 20
HUDSON NC
28638-9424
US

V. Phone/Fax

Practice location:
  • Phone: 828-758-7326
  • Fax: 828-754-5100
Mailing address:
  • Phone: 182-875-8732
  • Fax: 182-874-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number7413
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: