Individual provider Active NPI

Tamia Shaune Brown

  • Occupational Therapist
  • Stockbridge, GA
National Provider Identifier
1184887713
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004638 Issued in GA
Practice address
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone
(678) 604-5116
Fax
(678) 604-5589
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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 OT004638 GA Primary

Addresses

Primary practice location

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085

Mailing address

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-5116

Other identifiers 1

IdentifierTypeStateIssuer
527960088AMedicaidGA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT004638GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1184887713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-5116",
            "fax_number": "678-604-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-5116",
            "fax_number": "678-604-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TAMIA",
        "middle_name": "SHAUNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527960088A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.