Jemicah Mosby

Key facts

NPI

1194480764

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

004956 (GA)

Practice address

385 Sablewood Dr
Milton, GA 30004-8048

Phone

(770) 377-7633

NPI assigned

Nov 8, 2021

Sex

Male

Sole proprietor

No

Organizations & group practices 3

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.

• Legacy Healthcare Services, Inc. Physical Therapist · Dawsonville, GA · NPI 1528419751
  Medicare reassignment NPD GA · OCCUPATIONAL THERAPIST
• Legacy Healthcare Services, Inc. Physical Therapist · Winder, GA · NPI 1831619337
  Medicare reassignment NPD GA · OCCUPATIONAL THERAPIST
• Legacy Healthcare Services Inc Physical Therapist · Cary, NC · NPI 1225879489
  NPD OCCUPATIONAL THERAPIST

Medicare Care Compare profile

Specialty

Occupational Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services Inc (3,431 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 8, 2021.

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1194480764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 SABLEWOOD DR",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300048048",
            "telephone_number": "770-377-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 SABLEWOOD DR",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300048048",
            "telephone_number": "770-377-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBY",
        "first_name": "JEMICAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "004956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, GA

• Cobie C Miley, M.A. BCBA, LBA
• Milton Pediatric Dentistry and Orthodontics Corp
• Milton Physical Therapy, LLC
• Ethan Minkert
• Katherine Mitchell, RN
• Nirupama Arkonam Natarajan, MD
• Jasmine Thao Nguyen, FNP-BC
• Delight Obasi
• Onpoint Medical Supply, Inc
• Steven Francis Owens, P.T.

All providers in Milton, GA · Occupational Therapist in Georgia