NPIMap

Organization Active NPI

Tailored Occupational Therapy LLC

  • Specialist
  • Lithia Springs, GA
National Provider Identifier
1265500243
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT001309 Issued in GA
Legal business name
TAILORED OCCUPATIONAL THERAPY LLC
Practice address
351 Thornton Rd Ste 125
Lithia Springs, GA 30122-1589
Phone
(770) 577-0399
Fax
(678) 922-1515
NPI assigned
Nov 30, 2006
Last updated
Mar 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Dana L Harris, OTNPI 1144398116
Title
Ceo
Phone
(678) 637-7812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU
Physical Therapy Clinic/Center 261QP2000X NU
Specialist 174400000X OT001309 GA Primary

Addresses

Primary practice location

351 Thornton Rd Ste 125
Lithia Springs, GA 30122-1589

Mailing address

PO Box 943
Austell, GA 30168-1053
Phone (678) 637-7812

Other identifiers 1

IdentifierTypeStateIssuer
000683812CMedicaidGA

Other names 1

  • TAILORED FOR TOTS LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

351 Thornton Rd
Ste 125
Lithia Springs, GA 30122
Phone (770) 577-0399

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1265500243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 943",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301681053",
            "telephone_number": "678-637-7812",
            "fax_number": "678-922-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 THORNTON RD STE 125",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221589",
            "telephone_number": "770-577-0399",
            "fax_number": "678-922-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAILORED OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-637-7812",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "OT001309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000683812C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAILORED FOR TOTS LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lithia Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.