Active NPI
Kevin Jerome Harvey, MOT
- Occupational Therapist
- Douglasville, GA
National Provider Identifier
1649576398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT004319
- Practice address
- 9540 Fernandina Dr
Douglasville, GA 30135-2069 - Phone
- (404) 290-8825
- Fax
- (678) 715-6221
- NPI assigned
- Jan 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT004319 | GA | Primary |
Addresses
Primary practice location
9540 Fernandina Dr
Douglasville, GA 30135-2069
Mailing address
9540 Fernandina Dr
Douglasville, GA 30135-2069
Phone (404) 290-8825
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT004319 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1649576398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9540 FERNANDINA DR",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352069",
"telephone_number": "404-290-8825",
"fax_number": "678-715-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9540 FERNANDINA DR",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352069",
"telephone_number": "404-290-8825",
"fax_number": "678-715-6221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARVEY",
"first_name": "KEVIN",
"middle_name": "JEROME",
"name_prefix": "Mr.",
"credential": "MOT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-27",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT004319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.