Active NPI
Deandre Harrison, OT
- Occupational Therapist
- Atlanta, GA
National Provider Identifier
1366026502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT008051
- Practice address
- 6160 Peachtree Dunwoody Rd Ste B90
Atlanta, GA 30328-6040 - Phone
- (770) 673-0093
- Fax
- (770) 673-8368
- NPI assigned
- May 12, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT008051 | GA | Primary |
Addresses
Primary practice location
6160 Peachtree Dunwoody Rd Ste B90
Atlanta, GA 30328-6040
Mailing address
6160 Peachtree Dunwoody Rd Ste B90
Atlanta, GA 30328-6040
Phone (770) 673-0093
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT008051 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation Therapy Center-Alpharetta, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Roswell, GA
- NPI 1447283635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1366026502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6160 PEACHTREE DUNWOODY RD STE B90",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303286040",
"telephone_number": "770-673-0093",
"fax_number": "770-673-8368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6160 PEACHTREE DUNWOODY RD STE B90",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303286040",
"telephone_number": "770-673-0093",
"fax_number": "770-673-8368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "DEANDRE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-12",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT008051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.