Individual provider Active NPI

Erin E Moreno, OT

  • Occupational Therapist
  • Kennesaw, GA
National Provider Identifier
1003223017
Registry record updated Jul 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007618 Issued in GA
Practice address
4381 Bells Ferry Rd NW
Kennesaw, GA 30144-1309
Phone
(724) 816-1800
Fax
(865) 951-7273
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT007618 GA Primary

Addresses

Primary practice location

4381 Bells Ferry Rd NW
Kennesaw, GA 30144-1309

Mailing address

3243 Heritage Cir
Hendersonville, NC 28791-3553
Phone (828) 713-0560

Other names 1

  • Erin Regan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524000718 GA Practitioner - Occupational Therapist in Private Practice 6800110818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Servant Rehabilitation IncGroup PAC ID 5395168629, 18 clinicians

Practice addresses (Care Compare)

68 Breezy Valley Connector
Hiram, GA 30141-3054
Phone (828) 713-0560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Servant Rehabilitation, Inc. Occupational Therapist CurrentSince May 3, 2022 Accepting new patients
The Weston Group Inc. PastSince May 3, 2022 Accepting new patients

Locations

68 Breezy Valley Connector
Hiram, GA 30141
Phone (678) 973-1906

4381 Bells Ferry Rd NW
Kennesaw, GA 30144
Phone (724) 816-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1003223017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 HERITAGE CIR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913553",
            "telephone_number": "828-713-0560",
            "fax_number": "865-951-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 BELLS FERRY RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441309",
            "telephone_number": "724-816-1800",
            "fax_number": "865-951-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ERIN",
        "middle_name": "E",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "REGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.