Individual provider Active NPI

Tabitha Brown

  • Occupational Therapy Assistant
  • Rome, GA
National Provider Identifier
1053903450
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA001795 Issued in GA
Practice address
600 Eagle Lake TRL
Rome, GA 30165-2207
Phone
(706) 728-3600
NPI assigned
Feb 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2021

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 OTA001795 GA Primary

Addresses

Primary practice location

600 Eagle Lake TRL
Rome, GA 30165-2207

Mailing address

3917 S Little Sand Mountain Rd
Armuchee, GA 30105-4049
Phone (706) 859-1372

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
OTA001795GAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1053903450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 S LITTLE SAND MOUNTAIN RD",
            "city": "ARMUCHEE",
            "state": "GA",
            "postal_code": "301054049",
            "telephone_number": "706-859-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAGLE LAKE TRL",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652207",
            "telephone_number": "706-728-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TABITHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-07",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA001795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; 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.