Individual provider Active NPI

Tiara Racquel Jones, MS, OTR/L

  • Occupational Therapist
  • Martinez, GA
National Provider Identifier
1174126809
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007724 Issued in GA
Practice address
3580 River Watch Pkwy
Martinez, GA 30907-3682
Phone
(706) 364-3470
Fax
(706) 496-7789
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X PT006331 GA
Occupational Therapist 225X00000X OT007724 GA Primary

Addresses

Primary practice location

3580 River Watch Pkwy
Martinez, GA 30907-3682

Mailing address

3580 River Watch Pkwy
Martinez, GA 30907-3682
Phone (706) 364-3470

Other practice location 1

724 Greene St # 2
Augusta, GA 30901-2359
Phone (706) 722-2096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220324001069 GA Practitioner - Occupational Therapist in Private Practice 7810382033 Reassigns benefits to 1 organization
I20220328000850 SC Practitioner - Occupational Therapist in Private Practice 7810382033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT007724GAMDOccupational Therapist
PT006331GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sensational Kids Pediatric Rehabilitation & Counseling, Inc. CurrentSince Nov 22, 2020 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Occupational Therapist CurrentSince Mar 1, 2022 Accepting new patients
Fox Rehabilitation Ga, LLC Occupational Therapist CurrentSince Mar 1, 2022 Accepting new patients
Multidisciplinary Therapy Past Accepting new patients

Locations

3580 River Watch Pkwy
Martinez, GA 30907
Phone (706) 364-3470

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1174126809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 RIVER WATCH PKWY",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309073682",
            "telephone_number": "706-364-3470",
            "fax_number": "706-496-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 RIVER WATCH PKWY",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309073682",
            "telephone_number": "706-364-3470",
            "fax_number": "706-496-7789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 Greene St # 2",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012359",
            "country_code": "US",
            "telephone_number": "706-722-2096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "TIARA",
        "middle_name": "RACQUEL",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "PT006331",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.