Individual provider Active NPI

Rachel Layne Rackleff Brown, OTR/L

  • Occupational Therapist
  • Statesboro, GA
National Provider Identifier
1619643186
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008171 Issued in GA
Practice address
508 Gentilly Rd
Statesboro, GA 30458-5149
Phone
(912) 681-7768
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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 OT008171 GA Primary

Addresses

Primary practice location

508 Gentilly Rd
Statesboro, GA 30458-5149

Mailing address

205 Fallen Leaf Dr
Brooklet, GA 30415-0140
Phone (912) 682-9868

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
OT008171GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Spot LLC CurrentSince Aug 28, 2021 Accepting new patients

Locations

508 Gentilly Rd
Statesboro, GA 30458
Phone (912) 661-1900

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1619643186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 FALLEN LEAF DR",
            "city": "BROOKLET",
            "state": "GA",
            "postal_code": "304150140",
            "telephone_number": "912-682-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 GENTILLY RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585149",
            "telephone_number": "912-681-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RACHEL",
        "middle_name": "LAYNE RACKLEFF",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.