Individual provider Active NPI

Elizabeth Eldridge Jarrell, OTR/L

  • Occupational Therapist
  • Woodstock, GA
National Provider Identifier
1538620752
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007282 Issued in GA
Practice address
403 Waterfront CT
Woodstock, GA 30188-2730
Phone
(770) 298-6181
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 OT007282 GA Primary

Addresses

Primary practice location

403 Waterfront CT
Woodstock, GA 30188-2730

Mailing address

7308 Walden Crossing Dr
Canton, GA 30115-9539
Phone (770) 298-6181

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

LicenseStateTypeSpecialty
OT007282GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1538620752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 WALDEN CROSSING DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159539",
            "telephone_number": "770-298-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 WATERFRONT CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882730",
            "telephone_number": "770-298-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "ELIZABETH",
        "middle_name": "ELDRIDGE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.