Individual provider Active NPI

Marsha T. Youmans, MOT, OTR/L

  • Occupational Therapist
  • Lithonia, GA
National Provider Identifier
1083782346
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003960 Issued in GA
Practice address
4531 Idlewood Park
Lithonia, GA 30038-6255
Phone
(404) 307-9510
Fax
(770) 808-5920
NPI assigned
Dec 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 003960 GA
Occupational Therapist 225X00000X 003960 GA Primary

Addresses

Primary practice location

4531 Idlewood Park
Lithonia, GA 30038-6255

Mailing address

4531 Idlewood Park
Lithonia, GA 30038-6255
Phone (404) 307-9510

Other identifiers 3

IdentifierTypeStateIssuer
380693OtherGAWELLCARE
733249790BMedicaidGA
733249790CMedicaidGA

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
003960GAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1083782346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 IDLEWOOD PARK",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386255",
            "telephone_number": "404-307-9510",
            "fax_number": "770-808-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 IDLEWOOD PARK",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386255",
            "telephone_number": "404-307-9510",
            "fax_number": "770-808-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUMANS",
        "first_name": "MARSHA",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "003960",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "003960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "380693",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "733249790B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "733249790C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.