Active NPI
Angie R Hernandez, OTR/L
- Occupational Therapist
- Sugar Hill, GA
National Provider Identifier
1477857134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT004533
- Practice address
- 569 Emerald Lake LN
Sugar Hill, GA 30518-5600 - Phone
- (678) 765-2920
- NPI assigned
- Jan 10, 2011
- Last updated
- Jan 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT004533 | GA | Primary |
Addresses
Primary practice location
569 Emerald Lake LN
Sugar Hill, GA 30518-5600
Mailing address
569 Emerald Lake Lane
Sugar Hill, GA 30518
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT004533 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1477857134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "569 EMERALD LAKE LANE",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "30518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "569 EMERALD LAKE LN",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "305185600",
"telephone_number": "678-765-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "ANGIE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT004533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.