NPIMap

Organization Active NPI

Neuro-Developmental Treatment Programs, Inc.

Doing business as NDT Programs

  • Occupational Therapist
  • Augusta, GA
National Provider Identifier
1417924036
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NEURO-DEVELOPMENTAL TREATMENT PROGRAMS, INC.
Doing business as
NDT Programs
Practice address
817 Crawford Ave
Augusta, GA 30904-3772
Phone
(706) 736-1255
Fax
(706) 736-1258
NPI assigned
Mar 2, 2006
Last updated
Aug 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Ms. Shelly L Harris
Title
Back Office Manager
Phone
(706) 736-1255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X GA
Occupational Therapist 225X00000X GA Primary

Addresses

Primary practice location

817 Crawford Ave
Augusta, GA 30904-3772

Mailing address

817 Crawford Ave
Augusta, GA 30904-3772
Phone (706) 736-1255

Other identifiers 2

IdentifierTypeStateIssuer
300024827DMedicaidGA
GP1346MedicaidSC

Other names 1

  • NDT Programs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120717000089 GA Part B Supplier - Clinic/Group Practice 5092971242 Receives reassigned benefits from 10 practitioners
Practice locations: Augusta, GA

National Provider Directory

National Provider Directory

Locations

817 Crawford Ave
Augusta, GA 30904
Phone (706) 736-1255

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1417924036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CRAWFORD AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043772",
            "telephone_number": "706-736-1255",
            "fax_number": "706-736-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 CRAWFORD AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043772",
            "telephone_number": "706-736-1255",
            "fax_number": "706-736-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO-DEVELOPMENTAL TREATMENT PROGRAMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BACK OFFICE MANAGER",
        "authorized_official_telephone_number": "706-736-1255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300024827D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1346",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NDT Programs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NDT Programs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.