Individual provider Active NPI

Casey Tuell, MOT, OTR/L

  • Pediatric Occupational Therapist
  • Waverly, GA
National Provider Identifier
1336559335
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT007478 Issued in GA
Practice address
1454 Horseshoe Cove Rd
Waverly, GA 31565-2110
Phone
(850) 294-4666
NPI assigned
Apr 30, 2014
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4299 SC
Pediatric Occupational Therapist 225XP0200X OT007478 GA Primary

Addresses

Primary practice location

1454 Horseshoe Cove Rd
Waverly, GA 31565-2110

Mailing address

1454 Horseshoe Cove Rd
Waverly, GA 31565-2110
Phone (850) 294-4666

Other identifiers 2

IdentifierTypeStateIssuer
GP6269MedicaidSC
TH2750MedicaidSC

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
4299SCMDPhysical Therapist
OT007478GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Other Side of Play LLC Occupational Therapist CurrentSince Mar 30, 2025 Accepting new patients
Full Circle Pediatric Therapy Occupational Therapist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1336559335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 HORSESHOE COVE RD",
            "city": "WAVERLY",
            "state": "GA",
            "postal_code": "315652110",
            "telephone_number": "850-294-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 HORSESHOE COVE RD",
            "city": "WAVERLY",
            "state": "GA",
            "postal_code": "315652110",
            "telephone_number": "850-294-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUELL",
        "first_name": "CASEY",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4299",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT007478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6269",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH2750",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.