Individual provider Active NPI

Stephanie Manning Crider

  • Occupational Therapist
  • Cartersville, GA
National Provider Identifier
1124725387
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1155 Douthit Ferry Rd
Cartersville, GA 30120
Phone
(404) 798-6892
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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 Primary

Addresses

Primary practice location

1155 Douthit Ferry Rd
Cartersville, GA 30120

Mailing address

502 Riverbirch CT
Rockmart, GA 30153-8229
Phone (678) 640-1907

Other practice location 1

112 Yellow Jacket Dr
Calhoun, GA 30701
Phone (404) 798-6892

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223000046 GA Practitioner - Occupational Therapist in Private Practice 2466825435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizons Therapy Group, Inc.Group PAC ID 5496781627, 12 clinicians

Practice addresses (Care Compare)

258 Woodfall Rd
Cedartown, GA 30125-5904
Phone (678) 472-4042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of Ga PC PastSince Feb 7, 2022 Accepting new patients
Preferred Podiatry Group PC Past Accepting new patients

Organizations & group practices 3

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1124725387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 RIVERBIRCH CT",
            "city": "ROCKMART",
            "state": "GA",
            "postal_code": "301538229",
            "telephone_number": "678-640-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 DOUTHIT FERRY RD",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "404-798-6892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Yellow Jacket Dr",
            "address_purpose": "LOCATION",
            "city": "Calhoun",
            "state": "GA",
            "postal_code": "30701",
            "country_code": "US",
            "telephone_number": "404-798-6892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "STEPHANIE",
        "middle_name": "MANNING",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.