Individual provider Active NPI

Naeha Patel Sur, MS, OTR/L, CLC

  • Pediatric Occupational Therapist
  • Kennesaw, GA
National Provider Identifier
1447680434
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT005797 Issued in GA
Practice address
1772 Mountain Oak Rd NW
Kennesaw, GA 30152-4278
Phone
(678) 498-0588
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X 358932 GA
Pediatric Occupational Therapist 225XP0200X OT005797 GA Primary

Addresses

Primary practice location

1772 Mountain Oak Rd NW
Kennesaw, GA 30152-4278

Mailing address

1772 Mountain Oak Rd NW
Kennesaw, GA 30152-4278
Phone (678) 498-0588

Other practice location 1

9880 Hickory Flat Hwy
Woodstock, GA 30188-3081
Phone (770) 687-2542

Other practice location 2

3200 Highlands Pkwy SE
Suite 150
Smyrna, GA 30082-5166
Phone (770) 433-2300

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
358932GAMDLactation Consultant (Non-RN)
OT005797GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Growing by Play Pediatric Therapy, LLC Lactation Consultant, Non-RN CurrentSince Oct 21, 2025 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": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1447680434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 MOUNTAIN OAK RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524278",
            "telephone_number": "678-498-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 MOUNTAIN OAK RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524278",
            "telephone_number": "678-498-0588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9880 Hickory Flat Hwy",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301883081",
            "country_code": "US",
            "telephone_number": "770-687-2542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Highlands Pkwy SE",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300825166",
            "country_code": "US",
            "telephone_number": "770-433-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUR",
        "first_name": "NAEHA",
        "middle_name": "PATEL",
        "credential": "MS, OTR/L, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "GA",
            "license": "358932",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; 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.