Individual provider Active NPI

Janssen Morton Wellinghurst, OTR/L

  • Occupational Therapist
  • Athens, GA
National Provider Identifier
1417520255
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007177 Issued in GA
Practice address
801 Riverhill Dr
Athens, GA 30606-4067
Phone
(706) 369-7100
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT007177 GA Primary

Addresses

Primary practice location

801 Riverhill Dr
Athens, GA 30606-4067

Mailing address

429 Lake Vista Dr
Jefferson, GA 30549-4604
Phone (270) 293-1103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827002716 GA Practitioner - Occupational Therapist in Private Practice 7113322116 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT007177GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy LLC CurrentSince Aug 1, 2021 Accepting new patients
Empowerme Rehabilitation Georgia, LLC Occupational Therapist CurrentSince Jan 24, 2022 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Jul 15, 2021 Accepting new patients
Life Clinic of Ga PC PastSince Dec 3, 2022 Accepting new patients

Locations

762 N Main St
Alpharetta, GA 30009
Phone (678) 268-6335

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

562 Research Dr
Athens, GA 30605

915 Hawthorne Ave
Athens, GA 30606

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

125 Riverstone Ter
Canton, GA 30114
Phone (770) 479-0472

1479 Grove Park Dr
Columbus, GA 31904
Phone (706) 222-7188

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

7955 Majors Rd
Cumming, GA 30041
Phone (678) 648-5239

166 Oakland Pkwy
Leesburg, GA 31763
Phone (229) 232-8520

50 Brad Akins Dr
Winder, GA 30680

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 4

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1417520255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 LAKE VISTA DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305494604",
            "telephone_number": "270-293-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 RIVERHILL DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306064067",
            "telephone_number": "706-369-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGHURST",
        "first_name": "JANSSEN",
        "middle_name": "MORTON",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.