NPIMap

Organization Active NPI

Essential Therapy Services, Inc.

  • Occupational Therapist
  • Cumming, GA
National Provider Identifier
1508077991
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ESSENTIAL THERAPY SERVICES, INC.
Practice address
4640 Martin Rd
Cumming, GA 30041-5533
Phone
(678) 679-1261
Fax
(678) 250-9010
NPI assigned
May 25, 2007
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Tina Black, MS. OT/LNPI 1013087428
Title
Owner
Phone
(770) 378-5986

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

4640 Martin Rd
Cumming, GA 30041-5533

Mailing address

4640 Martin Rd
Cumming, GA 30041-5571
Phone (678) 679-1261

Other practice location 1

5286 Mountain Center Plz
Lula, GA 30554-2644
Phone (678) 679-1261

Other identifiers 1

IdentifierTypeStateIssuer
304370677AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Essential Therapy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5286 Mountain Center Plz
Lula, GA 30554
Phone (678) 679-1261

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1508077991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 MARTIN RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415571",
            "telephone_number": "678-679-1261",
            "fax_number": "678-250-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 MARTIN RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415533",
            "telephone_number": "678-679-1261",
            "fax_number": "678-250-9010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5286 Mountain Center Plz",
            "address_purpose": "LOCATION",
            "city": "Lula",
            "state": "GA",
            "postal_code": "305542644",
            "country_code": "US",
            "telephone_number": "678-679-1261",
            "fax_number": "678-250-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ESSENTIAL THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-378-5986",
        "authorized_official_credential": "MS. OT/L"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304370677A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.