Lillian Nicole Brewer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2631 Issued in SC

Practice address

4130 Fox Brush Dr
Evans, GA 30809-4856

Phone

(706) 825-9966

NPI assigned

Feb 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Your Aging Therapist LLCGroup PAC ID 6709285992, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Your Aging Therapist LLC

  • Occupational Therapist
  • Martinez, GA
  • NPI 1780263129
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1124267646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 FOX BRUSH DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094856",
            "telephone_number": "706-825-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 FOX BRUSH DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094856",
            "telephone_number": "706-825-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "LILLIAN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225X00000X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brabham Rehabilitation Services
• Brandon Wilde LLC
• Nathan H Brandon, M.D.
• Brandy Washington, LLC
• Kellie Brewer
• Micah R Brewer, PTA
• Dylan Bridges
• Kentarvius Brinkley, RBT
• Destinia Lashawn Brister
• Amone' Brookins

• Occupational Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.