NPIMap

Organization Active NPI

Keisha Patterson

  • Occupational Therapist
  • Ellenwood, GA
National Provider Identifier
1306534094
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
KEISHA PATTERSON
Practice address
3701 Fremont Dr
Ellenwood, GA 30294-6681
Phone
(205) 603-6929
NPI assigned
May 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Keisha Patterson, OTD, OTR/LNPI 1396131702
Title
Occupational Therapist
Phone
(205) 603-6929

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

3701 Fremont Dr
Ellenwood, GA 30294-6681

Mailing address

3701 Fremont Dr
Ellenwood, GA 30294-6681
Phone (205) 603-6929

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1306534094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 FREMONT DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946681",
            "telephone_number": "205-603-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 FREMONT DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946681",
            "telephone_number": "205-603-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEISHA PATTERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-29",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "205-603-6929",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.