NPIMap

Individual provider Active NPI

Joan Thiel

  • Pediatric Occupational Therapist
  • Lawrenceville, GA
National Provider Identifier
1306913496
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT000091 Issued in GA
Practice address
1509 Atkinson Rd
Suite 1100
Lawrenceville, GA 30043-7986
Phone
(770) 995-2379
Fax
(770) 995-2385
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT000091 GA
Pediatric Occupational Therapist 225XP0200X OT000091 GA Primary

Addresses

Primary practice location

1509 Atkinson Rd
Suite 1100
Lawrenceville, GA 30043-7986

Mailing address

1509 Atkinson Road
Suite 1100
Lawrenceville, GA 30043-4608
Phone (770) 995-2379

Other identifiers 3

IdentifierTypeStateIssuer
000758744AMedicaidGA
10037769MedicaidGA
306062MedicaidGA

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
OT000091GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Works,P.C. Past Accepting new patients
Physical Therapy Plus, Inc Past Accepting new patients

Organizations & group practices 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1306913496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 ATKINSON ROAD",
            "address_2": "SUITE 1100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434608",
            "telephone_number": "770-995-2379",
            "fax_number": "770-995-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 ATKINSON RD",
            "address_2": "SUITE 1100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437986",
            "telephone_number": "770-995-2379",
            "fax_number": "770-995-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "JOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "OT000091",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT000091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000758744A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10037769",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306062",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.