Marla Feazell – Occupational Therapy Assistant

Key facts

NPI: 1598044141
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapy Assistant 224Z00000X
License: 0000000113 (TN)
Practice address: 1094 Mulberry St
Loudon, TN 37774-1364
Phone: (865) 458-8900
Fax: (865) 458-8626
NPI assigned: Aug 15, 2011
Sex: Female
Sole proprietor: No

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.

Little Tennessee Valley Educational Cooperative Local Education Agency (LEA) · Loudon, TN · NPI 1114256039

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0000000113	TN	MD	Occupational Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Little Tennessee Valley Educational Cooperative		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapy Assistant	224Z00000X	0000000113	TN	Yes

Addresses

Primary practice location

1094 Mulberry St
Loudon, TN 37774-1364

Mailing address

1094 Mulberry St
Loudon, TN 37774-1364
Phone (865) 458-8900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 15, 2011.

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1598044141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MULBERRY ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741364",
            "telephone_number": "865-458-8900",
            "fax_number": "865-458-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 MULBERRY ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741364",
            "telephone_number": "865-458-8900",
            "fax_number": "865-458-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEAZELL",
        "first_name": "MARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "0000000113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

All providers in Loudon, TN · Occupational Therapy Assistant in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.