Individual provider Active NPI

Ta Niesha Toler

  • Occupational Therapist
  • Dacula, GA
National Provider Identifier
1265204754
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2089 Teron Trce Ste 120
Dacula, GA 30019
Phone
(577) 157-1519
NPI assigned
Oct 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 GA Primary

Addresses

Primary practice location

2089 Teron Trce Ste 120
Dacula, GA 30019

Mailing address

2089 Teron Trce
Dacula, GA 30019-1609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402004259 FL Practitioner - Occupational Therapist in Private Practice 7517305071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Ones Therapy Services, Inc. CurrentSince Oct 29, 2023 Accepting new patients
Central Florida Dreamplex LLC CurrentSince Mar 26, 2024 Accepting new patients

Locations

2400 S US Highway 27
Ste B201
Clermont, FL 34711
Phone (352) 606-0000

2400 S Highway 27
Ste B2
Clermont, FL 34711

5165 Adanson St
Orlando, FL 32804
Phone (407) 303-7600

2089 Teron Trce
Ste 120
Dacula, GA 30019
Phone (770) 904-2357

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1265204754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "30019",
            "telephone_number": "577-157-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLER",
        "first_name": "TA NIESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.