Individual provider Active NPI

Terry Cravens Jr., COTA

  • Occupational Therapy Assistant
  • Atlanta, GA
National Provider Identifier
1386099240
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA002007 Issued in GA
Practice address
3088 Lenox Rd NE
Atlanta, GA 30324-2894
Phone
(404) 846-8335
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA002007 GA Primary

Addresses

Primary practice location

3088 Lenox Rd NE
Atlanta, GA 30324-2894

Mailing address

1415 Red Tail CT
Mableton, GA 30126-1269
Phone (321) 914-9129

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
OTA002007GAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1386099240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 RED TAIL CT",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261269",
            "telephone_number": "321-914-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088 LENOX RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303242894",
            "telephone_number": "404-846-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "TERRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA002007",
            "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 Apr 28, 2016; 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.