Justin Oran McDivitt, OTD, R/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4071 Issued in TN

Practice address

815 S Walnut Ave
Cookeville, TN 38501-5956

Phone

(931) 646-7216

NPI assigned

Nov 30, 2010

Last updated

Nov 30, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Clinton, TN
  • NPI 1376073262

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1053613802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 NOTTINGHAM DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385064310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385015956",
            "telephone_number": "931-646-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDIVITT",
        "first_name": "JUSTIN",
        "middle_name": "ORAN",
        "name_prefix": "Dr.",
        "credential": "OTD, R/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "4071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber McClurkan, LCSW
• Micah McColloch, PTA
• Tammy McCoy, MS
• Ashleyaunna Marie McDaniels
• Anna Jill McDermott, OTR/L
• Aspen McDonald, FNP
• Megan McDonald, DPT
• Grayson McElroy, PHARMD
• McKayla McElwain
• Philip McGourty

• Occupational Therapist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.