Phu Tho Srikanchana

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT008486 Issued in GA

Practice address

1894 Ludovie LN
Decatur, GA 30033-1044

Phone

(678) 626-0557

NPI assigned

May 31, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Atlanta Pediatric Therapy, Inc.

  • Early Intervention Provider Agency
  • Chamblee, GA
  • NPI 1578622593
  NPD (past)
• Core Therapy Services, LLC

  • Behavior Analyst
  • Decatur, GA
  • NPI 1881043420

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1427741925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 OLD NORCROSS RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843119",
            "telephone_number": "404-423-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 LUDOVIE LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331044",
            "telephone_number": "678-626-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIKANCHANA",
        "first_name": "PHU THO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Spivey, PHARM.D.
• Patrica Ann Spratley, SLP
• Stacey B Spriggs, RN
• Jasmyne Renee Sprinkle, M.ED., APC
• Stefani Spruill, NP
• Jayanthi Srinivasiah, MD
• SSFS Consulting LLC
• Tynese St Cyr
• St Dominic Savio Motivational Place (DSMP), Inc.
• Lori Lynn St.Germain, PA-C

• Occupational Therapist in Decatur, GA
• Providers in Decatur, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.