Active NPI
Jada Davis
- Occupational Therapy Assistant
- Dalton, GA
National Provider Identifier
1518774686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA002560
- Practice address
- 1115 Professional Blvd
Dalton, GA 30720-2628 - Phone
- (706) 226-4642
- NPI assigned
- Dec 12, 2024
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | OTA002560 | GA | Primary |
Addresses
Primary practice location
1115 Professional Blvd
Dalton, GA 30720-2628
Mailing address
138 Curtis Cemetery Rd SE
Calhoun, GA 30701-3914
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 |
|---|---|---|---|
| OTA002560 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1518774686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 CURTIS CEMETERY RD SE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307013914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 PROFESSIONAL BLVD",
"city": "DALTON",
"state": "GA",
"postal_code": "307202628",
"telephone_number": "706-226-4642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JADA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-12",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA002560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.