Individual provider Active NPI

Maegan Alyssa Williams, OTR/L

  • Occupational Therapist
  • Rome, GA
National Provider Identifier
1417254665
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006291 Issued in GA
Practice address
304 E 6TH Ave
Rome, GA 30161-6000
Phone
(706) 378-9044
Fax
(706) 378-9046
NPI assigned
Feb 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Occupational Therapist 225X00000X OT006291 GA Primary

Addresses

Primary practice location

304 E 6TH Ave
Rome, GA 30161-6000

Mailing address

304 E 6TH Ave
Rome, GA 30161-6000
Phone (706) 378-9044

Other names 1

  • Miss Maegan Alyssa Pachomski 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

State licenses

LicenseStateTypeSpecialty
OT006291GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Children'S Services, Inc. Occupational Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1417254665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E 6TH AVE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616000",
            "telephone_number": "706-378-9044",
            "fax_number": "706-378-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E 6TH AVE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616000",
            "telephone_number": "706-378-9044",
            "fax_number": "706-378-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MAEGAN",
        "middle_name": "ALYSSA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAEGAN",
            "last_name": "PACHOMSKI",
            "middle_name": "ALYSSA",
            "prefix": "MISS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.