Individual provider Active NPI

Yvette Janene Forbes, COTA/L

  • Occupational Therapy Assistant
  • Lilburn, GA
National Provider Identifier
1356535652
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2752 Issued in AL
Practice address
4562 Lawrenceville Hwy NW
Suite 201
Lilburn, GA 30047-3618
Phone
(770) 806-4136
Fax
(770) 806-4139
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A00236 GA
Occupational Therapy Assistant 224Z00000X 2752 AL Primary

Addresses

Primary practice location

4562 Lawrenceville Hwy NW
Suite 201
Lilburn, GA 30047-3618

Mailing address

Career Staff Unlimited-Atlanta Allied
4562 Lawrenceville Highway Suite 201
Lilburn, GA 30047
Phone (770) 806-4136

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
A00236GAMDOccupational Therapy Assistant
2752ALMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1356535652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAREER STAFF UNLIMITED-ATLANTA ALLIED",
            "address_2": "4562 LAWRENCEVILLE HIGHWAY SUITE 201",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-806-4136",
            "fax_number": "770-806-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 201",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473618",
            "telephone_number": "770-806-4136",
            "fax_number": "770-806-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "YVETTE",
        "middle_name": "JANENE",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "A00236",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AL",
            "license": "2752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.