NPIMap

Individual provider Active NPI

Michelle Ann Good, OTR/L

  • Hand Occupational Therapist
  • St Simons Island, GA
National Provider Identifier
1508921990
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT002198 Issued in GA
Practice address
2601 Demere Rd
St Simons Island, GA 31522-1614
Phone
(912) 634-9945
Fax
(912) 638-1584
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 002198 GA
Hand Occupational Therapist 225XH1200X OT002198 GA Primary
Pediatric Occupational Therapist 225XP0200X OT002198 GA

Addresses

Primary practice location

2601 Demere Rd
St Simons Island, GA 31522-1614

Mailing address

409 Whitefield Ave.
St. Simons Island, GA 31522
Phone (912) 222-7413

Other names 1

  • Mrs. Shelly Ann Good Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
002198GAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Plus, Inc Past Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Past Accepting new patients
Physical Therapy Plus, Inc 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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1508921990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WHITEFIELD AVE.",
            "city": "ST. SIMONS ISLAND",
            "state": "GA",
            "postal_code": "31522",
            "telephone_number": "912-222-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 DEMERE RD",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221614",
            "telephone_number": "912-634-9945",
            "fax_number": "912-638-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "002198",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "OT002198",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT002198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "GOOD",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.