Active NPI
Randi Grayson, OTR/L
- Occupational Therapist
- Tullahoma, TN
National Provider Identifier
1265210447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 7779 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Results-Ast JV, LLC | Multi-Specialty | Current | Accepting new patients |
| Top Rehab Services, Inc. | Multi-Specialty | Past | 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.