Active NPI
Daniel McSpadden, COTA/L
- Occupational Therapy Assistant
- Gainesville, GA
National Provider Identifier
1043557556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA001355
- Practice address
- 4145 Misty Morning Way
Lanier Village Estates
Gainesville, GA 30506 - Phone
- (678) 450-3035
- Fax
- (770) 538-6054
- NPI assigned
- Jan 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA001355 | GA | Primary |
Addresses
Primary practice location
4145 Misty Morning Way
Lanier Village Estates
Gainesville, GA 30506
Mailing address
987 Peaceful Valley Dr
Cleveland, GA 30528-4258
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA001355 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357257600000",
"number": "1043557556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "987 PEACEFUL VALLEY DR",
"city": "CLEVELAND",
"state": "GA",
"postal_code": "305284258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4145 MISTY MORNING WAY",
"address_2": "LANIER VILLAGE ESTATES",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "30506",
"telephone_number": "678-450-3035",
"fax_number": "770-538-6054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCSPADDEN",
"first_name": "DANIEL",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-04",
"last_updated": "2013-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA001355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.