Individual provider Active NPI

Martha Evelyn Daniel, OTR/L

  • Hand Occupational Therapist
  • Memphis, TN
National Provider Identifier
1356862288
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
5251 Issued in TN
Practice address
3045 Kate Bond Rd
Memphis, TN 38133-4004
Phone
(901) 937-3200
Fax
(901) 383-1738
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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 OT006743 GA
Hand Occupational Therapist 225XH1200X 5251 TN Primary

Addresses

Primary practice location

3045 Kate Bond Rd
Memphis, TN 38133-4004

Mailing address

1765 Old West Broad St
BLDG 2 Ste 200
Athens, GA 30606-2853
Phone (706) 549-1663

Other practice location 1

1765 Old West Broad St
Athens, GA 30606-2853
Phone (706) 549-1663

Other practice location 2

3440 Highway 81
Loganville, GA 30052-9112
Phone (706) 549-1663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201218000038 TN Practitioner - Occupational Therapist in Private Practice 7113299785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone (901) 641-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5251TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC CurrentSince Mar 9, 2020 Accepting new patients
MSK Group, PC Occupational Therapist CurrentSince Mar 9, 2020 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients
MSK Group PC Past Accepting new patients

Locations

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1356862288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST",
            "address_2": "BLDG 2 STE 200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381334004",
            "telephone_number": "901-937-3200",
            "fax_number": "901-383-1738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Old West Broad St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062853",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3440 Highway 81",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300529112",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "MARTHA",
        "middle_name": "EVELYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006743",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "TN",
            "license": "5251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.