Active NPI
Scardy Adam
- Occupational Therapy Assistant
- Social Circle, GA
National Provider Identifier
1366029688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA002734
- Practice address
- 671 N Cherokee Rd
Social Circle, GA 30025-2886 - Phone
- (770) 464-2019
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA002734 | GA | |
| Occupational Therapy Assistant | 224Z00000X | OTA002734 | CA | Primary |
Addresses
Primary practice location
671 N Cherokee Rd
Social Circle, GA 30025-2886
Mailing address
3008 New Haven LN
Villa Rica, GA 30180-5810
Phone (260) 804-2505
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA002734 | CA | MD | Occupational Therapy Assistant |
| OTA002734 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1366029688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 NEW HAVEN LN",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301805810",
"telephone_number": "260-804-2505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "671 N CHEROKEE RD",
"city": "SOCIAL CIRCLE",
"state": "GA",
"postal_code": "300252886",
"telephone_number": "770-464-2019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAM",
"first_name": "SCARDY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-24",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA002734",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "OTA002734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Social Circle, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.