Timothy R Lupien, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT000594 Issued in GA

Practice address

5041 Dallas Hwy BLDG 1C
Powder Springs, GA 30127-6459

Phone

(770) 425-2151

Fax

(770) 425-5982

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• West Cobb Physical Therapy

  • Physical Therapist
  • Powder Springs, GA
  • NPI 1417048885
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1386707271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HWY BLDG 1C",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276459",
            "telephone_number": "770-425-2151",
            "fax_number": "770-425-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HWY BLDG 1C",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276459",
            "telephone_number": "770-425-2151",
            "fax_number": "770-425-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPIEN",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT000594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY/PTAN",
            "identifier": "GRP7271",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.