Active NPI
Kendall Merritt Lenz, OTR/L
- Pediatric Occupational Therapist
- Grovetown, GA
National Provider Identifier
1275269144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT008513
- Practice address
- 5176 Wrightsboro Rd
Grovetown, GA 30813-2802 - Phone
- (706) 842-3330
- NPI assigned
- Jul 25, 2022
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT008513 | GA | Primary |
Addresses
Primary practice location
5176 Wrightsboro Rd
Grovetown, GA 30813-2802
Mailing address
517 Pershing Dr
North Augusta, SC 29841-3661
Phone (678) 763-7908
Other practice location 1
4405 Evans To Locks Rd
Evans, GA 30809-3737
Phone (706) 854-1598
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | therapytailsga.com | Therapy Trails, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT008513 | GA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Home Pediatric Therapy Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1275269144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 PERSHING DR",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298413661",
"telephone_number": "678-763-7908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5176 WRIGHTSBORO RD",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308132802",
"telephone_number": "706-842-3330"
}
],
"practiceLocations": [
{
"address_1": "4405 Evans To Locks Rd",
"address_purpose": "LOCATION",
"city": "Evans",
"state": "GA",
"postal_code": "308093737",
"country_code": "US",
"telephone_number": "706-854-1598",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LENZ",
"first_name": "KENDALL",
"middle_name": "MERRITT",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-25",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "OT008513",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "therapytailsga.com",
"affiliation": "Y",
"affiliationName": "Therapy Trails, LLC",
"address_1": "5176 Wrightsboro Rd",
"city": "Grovetown",
"state": "GA",
"country_code": "US",
"postal_code": "308132802",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Grovetown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.