Individual provider Active NPI

Christine M Cavanaugh, OTR/L

  • Occupational Therapist
  • Roswell, GA
National Provider Identifier
1356527618
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT001809 Issued in GA
Practice address
345 Ridge CT
Roswell, GA 30076-2620
Phone
(770) 641-9239
Fax
(770) 641-9335
NPI assigned
Jan 17, 2008
Last updated
Jan 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT001809 GA Primary

Addresses

Primary practice location

345 Ridge CT
Roswell, GA 30076-2620

Mailing address

345 Ridge CT
Roswell, GA 30076-2620
Phone (770) 641-9239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325001902 GA Practitioner - Occupational Therapist in Private Practice 5294172334 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for the Visually Impaired CurrentSince Jan 21, 2024 Accepting new patients
Excellence in Therapy, Inc. Past Accepting new patients
Unique Therapy Services, LLC Occupational Therapist Past Accepting new patients

Locations

1488 Jesse Jewell Pkwy SE
Ste 200
Gainesville, GA 30501
Phone (404) 875-9011

Organizations & group practices 3

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": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1356527618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 RIDGE CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762620",
            "telephone_number": "770-641-9239",
            "fax_number": "770-641-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 RIDGE CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762620",
            "telephone_number": "770-641-9239",
            "fax_number": "770-641-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT001809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.