Individual provider Active NPI

Emily Paige Statham, OTR/L

  • Pediatric Occupational Therapist
  • Alpharetta, GA
National Provider Identifier
1295542983
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT007875 Issued in GA
Practice address
11785 Northfall LN Ste 501-502
Alpharetta, GA 30009-7971
Phone
(770) 569-2274
Fax
(770) 569-7432
NPI assigned
Dec 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT007875 GA Primary

Addresses

Primary practice location

11785 Northfall LN Ste 501-502
Alpharetta, GA 30009-7971

Mailing address

55 Nestlebrooke Dr
Dawsonville, GA 30534-7694

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

LicenseStateTypeSpecialty
OT007875GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatterbox Inc PastSince Nov 10, 2019 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": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1295542983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NESTLEBROOKE DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305347694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11785 NORTHFALL LN STE 501-502",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300097971",
            "telephone_number": "770-569-2274",
            "fax_number": "770-569-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHAM",
        "first_name": "EMILY",
        "middle_name": "PAIGE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT007875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.