Individual provider Active NPI

Stephanie Loveland Grant, OT

  • Occupational Therapist
  • Gainesville, GA
National Provider Identifier
1497715627
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT001427 Issued in GA
Practice address
3978 Pointe N
Gainesville, GA 30506-5385
Phone
(678) 696-1172
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 OT001427 GA Primary

Addresses

Primary practice location

3978 Pointe N
Gainesville, GA 30506-5385

Mailing address

3978 Pointe N
Gainesville, GA 30506-5385
Phone (678) 696-1172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000515 GA Practitioner - Occupational Therapist in Private Practice 4587699418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001427GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Impulse Physical Therapy LLC CurrentSince Dec 22, 2023 Accepting new patients
Chris Recknor, M.D. PC Past Accepting new patients
Uoc Health Services LLC Past Accepting new patients

Organizations & group practices 3

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1497715627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3978 POINTE N",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305065385",
            "telephone_number": "678-696-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 POINTE N",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305065385",
            "telephone_number": "678-696-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "STEPHANIE",
        "middle_name": "LOVELAND",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT001427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.