NPIMap

Individual provider Active NPI

Amber Jean Cantrell, MS, OTR/L

  • Specialist
  • Cumming, GA
National Provider Identifier
1396098463
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT005575 Issued in GA
Practice address
4640 Martin Rd
Suite 300
Cumming, GA 30041-5571
Phone
(678) 679-1261
Fax
(678) 679-1265
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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 OT005575 GA
Specialist 174400000X OT005575 GA Primary

Addresses

Primary practice location

4640 Martin Rd
Suite 300
Cumming, GA 30041-5571

Mailing address

4640 Martin Rd
Suite 300
Cumming, GA 30041-5571
Phone (678) 679-1261

Other identifiers 1

IdentifierTypeStateIssuer
003128747AMedicaidGA

Other names 1

  • Ms. Amber Jean Rogeres Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT005575GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapy Services, Inc. Occupational Therapist Past Accepting new patients
Essential Therapy Services Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1396098463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 MARTIN RD",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415571",
            "telephone_number": "678-679-1261",
            "fax_number": "678-679-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 MARTIN RD",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415571",
            "telephone_number": "678-679-1261",
            "fax_number": "678-679-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "AMBER",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MS,  OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005575",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "OT005575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003128747A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "ROGERES",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "MS/OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.