Individual provider Active NPI

Corey Whigham, OTR

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1063624682
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004293 Issued in GA
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

Updated by the provider on Jul 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
191707573AMedicaidGA

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

LicenseStateTypeSpecialty
OT004293GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Therapy Associates, L.L.C. Occupational Therapist PastSince Jul 21, 2008 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.

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.

Verify at the official NPI Registry.