Active NPI
Matt Herrin
- Occupational Therapist
- Rome, GA
National Provider Identifier
1114535655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT007798
- Practice address
- 212 W 3Rd St SW
Rome, GA 30165-2802 - Phone
- (706) 295-4242
- NPI assigned
- Jul 21, 2020
- Sex
- Male
- Sole proprietor
- No
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 | OT007798 | GA | Primary |
Addresses
Primary practice location
212 W 3Rd St SW
Rome, GA 30165-2802
Mailing address
365 S Industrial Blvd
Calhoun, GA 30701-3075
Phone (706) 624-3000
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 |
|---|---|---|---|
| OT007798 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Rehabilitation for Kids of Gordon County, Inc | Past | 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.
-
- Rehabilitation Clinic/Center
- Calhoun, GA
- NPI 1376513382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1114535655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 S INDUSTRIAL BLVD",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307013075",
"telephone_number": "706-624-3000",
"fax_number": "706-624-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 W 3RD ST SW",
"city": "ROME",
"state": "GA",
"postal_code": "301652802",
"telephone_number": "706-295-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRIN",
"first_name": "MATT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-21",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT007798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.