Individual provider Active NPI

Stephanie Harwood

  • Occupational Therapist
  • Waycross, GA
National Provider Identifier
1255030896
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008764 Issued in GA
Practice address
303 Pineview Dr
Waycross, GA 31501-5229
Phone
(912) 283-0777
NPI assigned
Mar 2, 2023
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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 OT008764 GA Primary

Addresses

Primary practice location

303 Pineview Dr
Waycross, GA 31501-5229

Mailing address

303 Pineview Dr
Waycross, GA 31501-5229
Phone (912) 614-7847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230429000166 GA Practitioner - Occupational Therapist in Private Practice 3779948526 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Clinic LLC CurrentSince Feb 16, 2023 Accepting new patients
Speech-Language Pathology Contractors, Inc. PastSince Feb 16, 2023 Accepting new patients

Locations

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

303 Pineview Dr
Waycross, GA 31501
Phone (912) 283-0777

Organizations & group practices 2

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": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1255030896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PINEVIEW DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015229",
            "telephone_number": "912-614-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PINEVIEW DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015229",
            "telephone_number": "912-283-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARWOOD",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.