Individual provider Active NPI

Randi Grayson, OTR/L

  • Occupational Therapist
  • Tullahoma, TN
National Provider Identifier
1265210447
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2110 N Jackson St
Tullahoma, TN 37388-2208
Phone
(931) 455-5189
Fax
(931) 393-2455
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

2110 N Jackson St
Tullahoma, TN 37388-2208

Mailing address

2110 N Jackson St
Tullahoma, TN 37388-2208
Phone (931) 455-5189

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208000257 TN Practitioner - Occupational Therapist in Private Practice 4880037712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7779TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Multi-Specialty CurrentSince Dec 6, 2023 Accepting new patients
Top Rehab Services, Inc. Multi-Specialty PastSince Sep 24, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1265210447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882208",
            "telephone_number": "931-455-5189",
            "fax_number": "931-393-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882208",
            "telephone_number": "931-455-5189",
            "fax_number": "931-393-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "RANDI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

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