Jill Stanton

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT006415 Issued in GA

Practice address

20 Pointe North Dr Ste 109
Cartersville, GA 30120-7955

Phone

(678) 524-1262

Fax

(470) 588-8934

NPI assigned

Mar 30, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Functional Fun, LLC

  • Specialist
  • Cartersville, GA
  • NPI 1952994519
  NPD Authorized official

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1154784064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 COUNTRYSIDE PL SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808251",
            "telephone_number": "678-524-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POINTE NORTH DR STE 109",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301207955",
            "telephone_number": "678-524-1262",
            "fax_number": "470-588-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT006415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003178127B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barrett Allen Staley
• Kimberly Ann Stallings, NP-C
• Amanda Stanley, PHARMD
• Steve Stanley, DPT
• Stanton Optical
• Sarah Nicole Steele
• Sheri Lyn Steffey
• Steven J Garber, D.C., P.C.
• Lauraanne Jordan Stewart, DPT
• Natalie Holland Stewart, NP-C

• Pediatric Occupational Therapist in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.