Jennie Chambliss, OTR/L, OTM

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

6450 Spalding Dr
Peachtree Corners, GA 30092-4650

Phone

(847) 683-3628

NPI assigned

Dec 5, 2019

Last updated

Dec 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1346887726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 LAKEHURST CT SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300803105",
            "telephone_number": "404-291-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 SPALDING DR",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924650",
            "telephone_number": "847-683-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLISS",
        "first_name": "JENNIE",
        "credential": "OTR/L, OTM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007579",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "OT007579",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.