NPIMap

Organization Active NPI

Progress Village Pediatric Therapy Services

  • Occupational Therapist
  • Decatur, GA
National Provider Identifier
1144593047
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001419 Issued in GA
Legal business name
PROGRESS VILLAGE PEDIATRIC THERAPY SERVICES
Practice address
2385 Lawrenceville Hwy Ste a
Decatur, GA 30033-3168
Phone
(404) 289-4270
Fax
(404) 289-4428
NPI assigned
Feb 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Authorized official

Name
Dionne Brunson, OTR/L
Title
Owner
Phone
(404) 932-3440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 001419 GA Primary

Addresses

Primary practice location

2385 Lawrenceville Hwy Ste a
Decatur, GA 30033-3168

Mailing address

2949 Stonecrest PT
Conyers, GA 30094-4955
Phone (404) 932-3440

Other practice location 1

2395 Wall St SE Ste 290
Conyers, GA 30013-6703
Phone (404) 289-4270

National Provider Directory

National Provider Directory

Locations

2385 Lawrenceville Hwy
Ste A
Decatur, GA 30033
Phone (404) 289-4270

2385 Lawrenceville Hwy
Ste B1
Decatur, GA 30033

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732838400000",
    "number": "1144593047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 STONECREST PT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944955",
            "telephone_number": "404-932-3440",
            "fax_number": "770-483-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY STE A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333168",
            "telephone_number": "404-289-4270",
            "fax_number": "404-289-4428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2395 Wall St SE Ste 290",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300136703",
            "country_code": "US",
            "telephone_number": "404-289-4270",
            "fax_number": "470-276-3082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROGRESS VILLAGE PEDIATRIC THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A",
        "authorized_official_last_name": "BRUNSON",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-932-3440",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "001419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.