Active NPI
Victoria Davis
- Occupational Therapist
- Fayetteville, GA
National Provider Identifier
1104716729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT009576
- Practice address
- 290 Highway 314 Ste B
Fayetteville, GA 30214-7813 - Phone
- (404) 994-7727
- Fax
- (404) 994-7728
- NPI assigned
- Jul 7, 2025
- 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 | OT009576 | GA | Primary |
Addresses
Primary practice location
290 Highway 314 Ste B
Fayetteville, GA 30214-7813
Mailing address
4701 Flat Shoals Rd Apt 15C
Union City, GA 30291-2117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
7 Clyde Rd
Somerset, NJ 08873-5049
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT009576 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Tune Physical Therapy | Current | 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.
-
- Physical Therapist
- Atlanta, GA
- NPI 1023544624
-
- Physical Therapist
- Atlanta, GA
- NPI 1194696112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1104716729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 FLAT SHOALS RD APT 15C",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302912117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 HIGHWAY 314 STE B",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147813",
"telephone_number": "404-994-7727",
"fax_number": "404-994-7728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "VICTORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-07",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT009576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.