Away We Go Pediatric Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT004278 Issued in GA

Legal business name

AWAY WE GO PEDIATRIC THERAPY, LLC

Practice address

950 Sweet Birch Way
Cumming, GA 30040-1006

Phone

(404) 358-1925

NPI assigned

May 3, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Alicia Ann Harris, MS, OTR/LNPI 1265636716

Title

Occupational Therapist

Phone

40435281925

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alicia Ann Harris, MS, OTR/L

  • Occupational Therapist
  • Cumming, GA
  • NPI 1265636716
  NPD (past) Authorized official

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1649625161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 SWEET BIRCH WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401006",
            "telephone_number": "404-358-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 SWEET BIRCH WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401006",
            "telephone_number": "404-358-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAY WE GO PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "40435281925",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103089875",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.