Individual provider Active NPI

Lindsay Lively

  • Occupational Therapist
  • Augusta, GA
National Provider Identifier
1629564968
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004777 Issued in GA
Practice address
3725 Wheeler Rd
Augusta, GA 30909-6623
Phone
(706) 868-6500
NPI assigned
Jul 10, 2018
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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 OT004777 GA Primary

Addresses

Primary practice location

3725 Wheeler Rd
Augusta, GA 30909-6623

Mailing address

3709 Pebble Beach Dr
Martinez, GA 30907-9091

Other names 1

  • Lindsay Lively Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605003222 GA Practitioner - Occupational Therapist in Private Practice 6901139989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

255 Vaughn Dr
Alpharetta, GA 30009-2415
Phone (770) 521-9707

3725 Wheeler Rd
Augusta, GA 30909-6623
Phone (706) 364-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT004777GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Apr 22, 2024 Accepting new patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Apr 25, 2024 Accepting new patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Apr 22, 2024 Accepting new patients

Locations

3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1629564968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 PEBBLE BEACH DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 WHEELER RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096623",
            "telephone_number": "706-868-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "LIVELY",
            "credential": "OT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.