Individual provider Active NPI

Melissa Yvette Hoffman, OTR L

  • Pediatric Occupational Therapist
  • Valdosta, GA
National Provider Identifier
1124053947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT000829 Issued in GA
Practice address
3021 Kensington LN
Valdosta, GA 31602-4010
Phone
(229) 242-6795
Fax
(229) 219-2280
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT000829 GA Primary

Addresses

Primary practice location

3021 Kensington LN
Valdosta, GA 31602-4010

Mailing address

3021 Kensington LN
Valdosta, GA 31602-4010
Phone (229) 242-6795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616000735 GA Practitioner - Occupational Therapist in Private Practice 2466874722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutherland Physical Therapy IncGroup PAC ID 0042315582, 6 clinicians

Practice addresses (Care Compare)

5108 Northwind Blvd
Valdosta, GA 31605-7672
Phone (229) 244-1201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sutherland Physical Therapy, Inc. CurrentSince May 22, 2020 Accepting new patients

Locations

2704 N Oak St
Bldg A2
Valdosta, GA 31602
Phone (229) 245-1480

5108 Northwind Blvd
Valdosta, GA 31605
Phone (229) 244-1201

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124053947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 KENSINGTON LN",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316024010",
            "telephone_number": "229-242-6795",
            "fax_number": "229-219-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 KENSINGTON LN",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316024010",
            "telephone_number": "229-242-6795",
            "fax_number": "229-219-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MELISSA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "OTR L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT000829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.