Individual provider Active NPI

Diana Marie Tompkins, OTR/L

  • Pediatric Occupational Therapist
  • Statesboro, GA
National Provider Identifier
1205011194
Registry record updated Jan 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT003264 Issued in GA
Practice address
109 S Zetterower Ave
Statesboro, GA 30458-4898
Phone
(912) 489-1258
Fax
(912) 764-7006
NPI assigned
Jan 9, 2008
Last updated
Jan 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT003264 GA Primary

Addresses

Primary practice location

109 S Zetterower Ave
Statesboro, GA 30458-4898

Mailing address

1099 Johnny Brannen Rd
Statesboro, GA 30458-6576
Phone (912) 856-3247

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
OT003264GAMDPediatric Occupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200700800000",
    "number": "1205011194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 JOHNNY BRANNEN RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304586576",
            "telephone_number": "912-856-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S ZETTEROWER AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584898",
            "telephone_number": "912-489-1258",
            "fax_number": "912-764-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT003264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.