Provider Demographics
NPI:1134395783
Name:KAMPSCHROEDER, AMY (OTR/L)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KAMPSCHROEDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MILITARY CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-9737
Mailing Address - Country:US
Mailing Address - Phone:910-392-0080
Mailing Address - Fax:910-392-4686
Practice Address - Street 1:500 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-9737
Practice Address - Country:US
Practice Address - Phone:910-392-0080
Practice Address - Fax:910-392-4686
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301913Medicaid
NC14118OtherBCBS
NC186944OtherMEDCOST