Active NPI
Lauren Douglas
- Occupational Therapist
- Greenville, SC
National Provider Identifier
1063836054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4945
- Practice address
- 29 N Academy St
Greenville, SC 29601-2629 - Phone
- (864) 331-1350
- NPI assigned
- Feb 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2416460 | GA | |
| Pediatric Occupational Therapist | 225XP0200X | 4945 | SC | |
| Occupational Therapist | 225X00000X | 4945 | SC | Primary |
Addresses
Primary practice location
29 N Academy St
Greenville, SC 29601-2629
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other practice location 1
9 Maple Tree Ct
Greenville, SC 29615-4070
Phone (864) 627-0009
Other practice location 2
4116 Arkwright Rd
Macon, GA 31210-1707
Phone (478) 477-0601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | SC |
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 |
|---|---|---|---|
| 4945 | SC | MD | Physical Therapist |
| 2416460 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1063836054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 N ACADEMY ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012629",
"telephone_number": "864-331-1350"
}
],
"practiceLocations": [
{
"address_1": "9 Maple Tree Ct",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296154070",
"country_code": "US",
"telephone_number": "864-627-0009",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4116 Arkwright Rd",
"address_purpose": "LOCATION",
"city": "Macon",
"state": "GA",
"postal_code": "312101707",
"country_code": "US",
"telephone_number": "478-477-0601",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUGLAS",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-11",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "2416460",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "SC",
"license": "4945",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "4945",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.