Individual provider Active NPI

Gracen Farr, COTA/L

  • Occupational Therapy Assistant
  • North Augusta, SC
National Provider Identifier
1649168402
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5781 Issued in SC
Practice address
1367 W Martintown Rd Ste 1&2
North Augusta, SC 29860-7616
Phone
(803) 617-7523
Fax
(803) 386-0362
NPI assigned
Jun 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5781 SC Primary

Addresses

Primary practice location

1367 W Martintown Rd Ste 1&2
North Augusta, SC 29860-7616

Mailing address

1367 W Martintown Rd Ste 1&2
North Augusta, SC 29860-7616
Phone (803) 617-7523

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Pals LLC CurrentSince Jun 29, 2025 Accepting new patients

Locations

1367 W Martintown Rd
Ste 12
North Augusta, SC 29860
Phone (803) 336-8587

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": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1649168402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 W MARTINTOWN RD STE 1&2",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298607616",
            "telephone_number": "803-617-7523",
            "fax_number": "803-386-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 W MARTINTOWN RD STE 1&2",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298607616",
            "telephone_number": "803-617-7523",
            "fax_number": "803-386-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARR",
        "first_name": "GRACEN",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Augusta, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.