Individual provider Active NPI

Rachel L Scarboro, OTD, OTR/L

  • Occupational Therapist
  • Canton, GA
National Provider Identifier
1104503010
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008796 Issued in GA
Practice address
206 Bridgewater TRL
Canton, GA 30115-4566
Phone
(770) 758-8913
Fax
(404) 779-7547
NPI assigned
Jul 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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 OT008796 GA Primary

Addresses

Primary practice location

206 Bridgewater TRL
Canton, GA 30115-4566

Mailing address

206 Bridgewater TRL
Canton, GA 30115-4566
Phone (770) 758-8913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312000723 GA Practitioner - Occupational Therapist in Private Practice 3779004361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Florida College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live to the Max LLCGroup PAC ID 6002263217, 2 clinicians

Practice addresses (Care Compare)

Canton, GA 30115
Phone (229) 894-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Live to the Max LLC Occupational Therapist CurrentSince Jan 26, 2025 Accepting new patients

Organizations & group practices 1

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": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1104503010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BRIDGEWATER TRL",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154566",
            "telephone_number": "770-758-8913",
            "fax_number": "404-779-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BRIDGEWATER TRL",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154566",
            "telephone_number": "770-758-8913",
            "fax_number": "404-779-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBORO",
        "first_name": "RACHEL",
        "middle_name": "L",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.