Active NPI
Kristin Boatner, OT
- Pediatric Occupational Therapist
- Hiram, GA
National Provider Identifier
1285729434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 001622
- Practice address
- 262 Lakeview LN
Hiram, GA 30141-4424 - Phone
- (770) 361-4124
- Fax
- (770) 445-3073
- NPI assigned
- Oct 4, 2006
- 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 | 001622 | GA | Primary |
Addresses
Primary practice location
262 Lakeview LN
Hiram, GA 30141-4424
Mailing address
262 Lakeview LN
Hiram, GA 30141-4424
Phone (770) 361-4124
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobility Physical Therapy | 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.
-
- Rehabilitation Clinic/Center
- Powder Springs, GA
- NPI 1689817850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285729434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 LAKEVIEW LN",
"city": "HIRAM",
"state": "GA",
"postal_code": "301414424",
"telephone_number": "770-361-4124",
"fax_number": "770-445-3073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 LAKEVIEW LN",
"city": "HIRAM",
"state": "GA",
"postal_code": "301414424",
"telephone_number": "770-361-4124",
"fax_number": "770-445-3073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOATNER",
"first_name": "KRISTIN",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "001622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hiram, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.