Karen Bomar Nickerson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT007352 Issued in GA

Practice address

76A Camp Creek Rd SW
Lilburn, GA 30047-3909

Phone

(404) 805-6482

NPI assigned

Apr 8, 2019

Last updated

Apr 8, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Rehabilitation Ga, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1023544624

  Occupational Therapist

  Medicare reassignment NPD
• Cobblestone Pathways, LLC

  dba Cobblestone Therapy Group

  • Speech-Language Pathologist
  • Roswell, GA
  • NPI 1528171535
  NPD (past)

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1144783002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76A CAMP CREEK RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473909",
            "telephone_number": "404-805-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76A CAMP CREEK RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473909",
            "telephone_number": "404-805-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KAREN",
        "middle_name": "BOMAR",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Nguyen
• Le Phuong Nguyen
• Oanh Hoang Nguyen, LPN
• Phuong Uyen Bao Nguyen, PA-C
• Sakari Veda-Jean Nichols, LMT
• Heather-Leigh Owens Nies, MSW, LCSW, LMSW
• Andrea Nihei, REGISTERED BEHAVIOR
• Farhad Nikounejad
• Aja Nixon
• Neda Nore, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.