Wonder Therapeutic Services LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

WONDER THERAPEUTIC SERVICES LLC

Practice address

4875 Hog Mountain Rd Ste B
Flowery Branch, GA 30542-6450

Phone

(404) 406-8272

Fax

(770) 965-1008

NPI assigned

Oct 12, 2022

Organization subpart

No

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

Authorized official

Name

Tara B Feddern, OTR/LNPI 1639693278

Title

Ceo

Phone

(678) 960-3063

Specialties & licenses 3

Addresses

Locations

Practitioners 3

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

• Tara Banks Feddern, OTR/L

  • Pediatric Occupational Therapist
  • Buford, GA
  • NPI 1639693278
  NPD Authorized official
• Bethany Bearden, OTR/L

  • Occupational Therapist
  • Buford, GA
  • NPI 1831425149
  NPD (past)
• Katherine Rebecca Gilliam, MOT, OTR/L

  • Occupational Therapist
  • Woodstock, GA
  • NPI 1275322133
  NPD (past)

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1356067219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 CRESTVIEW WAY",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423501",
            "telephone_number": "404-406-8272",
            "fax_number": "404-738-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 HOG MOUNTAIN RD STE B",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305426450",
            "telephone_number": "404-406-8272",
            "fax_number": "770-965-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDER THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "FEDDERN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-960-3063",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willowwood Pac LLC
• Barbara Wilson, PH.D., LPC
• Christiane Wilson
• Latoya Wilson, CNA
• Pamela Wilson, OTR/L
• Philip Wong
• Linda Cheryl Woughter, ARNP
• Amy Wright, M.S., CCC-SLP
• Rebekah Annebelle Wright, PHARM.D.
• Stacey Anne Wrightsman, MS, LPC-MHSP

• Occupational Therapist in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.