Active NPI
Corey Whigham, OTR
- Occupational Therapist
- Atlanta, GA
National Provider Identifier
1063624682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT004293
- Practice address
- 4520 Creekside CV
Atlanta, GA 30349-3957 - Phone
- (251) 379-2233
- Fax
- (678) 519-1049
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225X00000X | OT004293 | GA | Primary |
Addresses
Primary practice location
4520 Creekside CV
Atlanta, GA 30349-3957
Mailing address
4520 Creekside CV
Atlanta, GA 30349-3957
Phone (251) 379-2233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 191707573A | Medicaid | GA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT004293 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Momentum Therapy Associates, L.L.C. | Occupational Therapist | Past | Accepting new patients |
| Inertia Rehabilitation Associates | Past | Accepting new patients |
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.
-
- Occupational Therapist
- Atlanta, GA
- NPI 1215190368
-
- Physical Therapy Clinic/Center
- Alpharetta, GA
- NPI 1811050800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216944000000",
"number": "1063624682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 CREEKSIDE CV",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303493957",
"telephone_number": "251-379-2233",
"fax_number": "678-519-1049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 CREEKSIDE CV",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303493957",
"telephone_number": "251-379-2233",
"fax_number": "678-519-1049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHIGHAM",
"first_name": "COREY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2008-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT004293",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "191707573A",
"state": "GA"
}
],
"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 Jul 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.