Individual provider Active NPI

Jessica Sledge, OTA001521

  • Occupational Therapy Assistant
  • Atlanta, GA
National Provider Identifier
1013522556
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA001521 Issued in GA
Practice address
690 Mount Vernon Hwy NE
Atlanta, GA 30328-4221
Phone
(404) 843-8857
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA001521 GA Primary

Addresses

Primary practice location

690 Mount Vernon Hwy NE
Atlanta, GA 30328-4221

Mailing address

2700 Pine Tree Rd NE Unit 3006
Atlanta, GA 30324-5676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA001521GAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1013522556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 PINE TREE RD NE UNIT 3006",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MOUNT VERNON HWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284221",
            "telephone_number": "404-843-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEDGE",
        "first_name": "JESSICA",
        "credential": "OTA001521",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA001521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.