Individual provider Active NPI

Mary Katherine Standard

  • Pediatric Occupational Therapist
  • Augusta, GA
National Provider Identifier
1649750472
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
2315 Central Ave Ste C
Augusta, GA 30904-6246
Phone
(706) 364-6172
Fax
(706) 262-2893
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

2315 Central Ave Ste C
Augusta, GA 30904-6246

Mailing address

2315 Central Ave Ste C
Augusta, GA 30904-6246
Phone (706) 364-6172

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

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1649750472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 CENTRAL AVE STE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046246",
            "telephone_number": "706-364-6172",
            "fax_number": "706-262-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 CENTRAL AVE STE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046246",
            "telephone_number": "706-364-6172",
            "fax_number": "706-262-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDARD",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 21, 2018; 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.