Active NPI
Jule G Kagan, MOT-OTRL
- Occupational Therapist
- Kennesaw, GA
National Provider Identifier
1073680732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT002591
- Practice address
- 2877 Cressington BND NW
Kennesaw, GA 30144-6090 - Phone
- (770) 479-1950
- NPI assigned
- Nov 29, 2006
- Last updated
- Mar 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | OT002591 | GA | Primary |
Addresses
Primary practice location
2877 Cressington BND NW
Kennesaw, GA 30144-6090
Mailing address
2877 Cressington BND NW
Kennesaw, GA 30144-6090
Phone (770) 479-1950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000903724B | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT002591 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1073680732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2877 CRESSINGTON BND NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301446090",
"telephone_number": "770-479-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2877 CRESSINGTON BND NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301446090",
"telephone_number": "770-479-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAGAN",
"first_name": "JULE",
"middle_name": "G",
"credential": "MOT-OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT002591",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000903724B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
- Sarah Julius, FNP, DNP
- Carly Junkins, PTA003959
- Just Breathe Wellness and Healing Center LLC
- Just for Kids Physical Therapy, Inc.
- Kadner Corporation (Georgia EMS)
- Kaiser Foundation Health Plan of Georgia Inc (Kaiser Permanente Townpark Infusion Pharmacy)
- Kaiser Foundation Health Plan of Georgia Inc (Kaiser Permanente Townpark Clinic Pharmacy)
- Kaiser Foundation Health Plan of Georgia Inc.
- Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente)
- Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Townpark)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.