Individual provider Active NPI

Evan Drew Brooks, OTR/L

  • Occupational Therapist
  • Carrollton, GA
National Provider Identifier
1144794322
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
007748 Issued in GA
Practice address
1124 N Park St
Carrollton, GA 30117-2395
Phone
(770) 834-0873
NPI assigned
Jan 21, 2019
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13034 MA
Occupational Therapist 225X00000X 007748 GA Primary

Addresses

Primary practice location

1124 N Park St
Carrollton, GA 30117-2395

Mailing address

1124 N Park St
Carrollton, GA 30117-2395
Phone (770) 834-0873

Other practice location 1

812 S Park St
Carrollton, GA 30117-4412
Phone (770) 834-7436

Other identifiers 1

IdentifierTypeStateIssuer
003263393BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250313001056 GA Practitioner - Occupational Therapist in Private Practice 2163943655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrollton Orthopaedic Clinic PCGroup PAC ID 7810989183, 31 clinicians

Practice addresses (Care Compare)

1124 N Park St
Suite M
Carrollton, GA 30117-2282
Phone (770) 834-0873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007748GAMDOccupational Therapist
13034MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Orthopaedic Clinic PC Occupational Therapist CurrentSince Mar 31, 2025 Accepting new patients
West Ga. Nurse Anesthesia, LLC Past Accepting new patients

Locations

1124 N Park St
Ste M
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Ste 101
Carrollton, GA 30117
Phone (770) 834-0873

812 S Park St
Carrollton, GA 30117
Phone (770) 834-7436

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1144794322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 N PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172395",
            "telephone_number": "770-834-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 N PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172395",
            "telephone_number": "770-834-0873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 S Park St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301174412",
            "country_code": "US",
            "telephone_number": "770-834-7436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "EVAN",
        "middle_name": "DREW",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13034",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "007748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003263393B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.