Provider Demographics
NPI:1326685835
Name:WHELTON, MEGAN (OTR)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WHELTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 GARDEN SIDE WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1031 PEMBERTON HILL RD STE 101
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4278
Practice Address - Country:US
Practice Address - Phone:919-372-5489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11381225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11381OtherOCCUPATIONAL THERAPY LICENSE