Individual provider Active NPI

Bryson May Green, OTR/L

  • Occupational Therapist
  • Cumming, GA
National Provider Identifier
1629433818
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006193 Issued in GA
Practice address
1389 Weber Industrial Dr
Cumming, GA 30041-6468
Phone
(770) 886-6204
Fax
(678) 261-6421
NPI assigned
Dec 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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 OT006193 GA Primary

Addresses

Primary practice location

1389 Weber Industrial Dr
Cumming, GA 30041-6468

Mailing address

1389 Weber Industrial Dr
Cumming, GA 30041-6468
Phone (770) 886-6204

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
OT006193GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Building Bridges Therapy Inc Occupational Therapist 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": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1629433818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 WEBER INDUSTRIAL DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416468",
            "telephone_number": "770-886-6204",
            "fax_number": "678-261-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 WEBER INDUSTRIAL DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416468",
            "telephone_number": "770-886-6204",
            "fax_number": "678-261-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRYSON",
        "middle_name": "MAY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.