Active NPI
Nika Freudenberg, OTR/L
- Pediatric Occupational Therapist
- Roswell, GA
National Provider Identifier
1528452158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT006109
- Practice address
- 3200 Brookside Dr
Roswell, GA 30076-5539 - Phone
- (404) 451-4702
- NPI assigned
- Mar 20, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT006109 | GA | Primary |
Addresses
Primary practice location
3200 Brookside Dr
Roswell, GA 30076-5539
Mailing address
3200 Brookside Dr
Roswell, GA 30076-5539
Phone (404) 451-4702
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 |
|---|---|---|---|
| OT006109 | GA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cobblestone Pathways, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1426809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1528452158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 BROOKSIDE DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765539",
"telephone_number": "404-451-4702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 BROOKSIDE DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765539",
"telephone_number": "404-451-4702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREUDENBERG",
"first_name": "NIKA",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-20",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "OT006109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.