Amanda Fragulis, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT005743 Issued in GA

Practice address

294 Rope Mill Rd
Woodstock, GA 30188-2612

Phone

(770) 296-1513

NPI assigned

Jan 20, 2020

Last updated

Jan 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Ead Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1629608583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 ROPE MILL RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882612",
            "telephone_number": "770-296-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 ROPE MILL RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882612",
            "telephone_number": "770-296-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGULIS",
        "first_name": "AMANDA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "EAD",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.