Individual provider Active NPI

Mary Zamorski, OTR

  • Occupational Therapist
  • Canton, GA
National Provider Identifier
1164596292
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003695 Issued in GA
Practice address
172 Birchwood Pass
Canton, GA 30114-7751
Phone
(678) 522-1078
Fax
(678) 985-3953
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 003695 GA Primary

Addresses

Primary practice location

172 Birchwood Pass
Canton, GA 30114-7751

Mailing address

172 Birchwood Pass
Canton, GA 30114-7751
Phone (678) 522-1078

Other identifiers 1

IdentifierTypeStateIssuer
965598604BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003695GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1164596292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 BIRCHWOOD PASS",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147751",
            "telephone_number": "678-522-1078",
            "fax_number": "678-985-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 BIRCHWOOD PASS",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147751",
            "telephone_number": "678-522-1078",
            "fax_number": "678-985-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORSKI",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "003695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "965598604B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

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