Active NPI
Mary Siatkowski, OTR,L
- Occupational Therapist
- Suwanee, GA
National Provider Identifier
1659462612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT001466
- Practice address
- 3905 Johns Creek CT
Suite 250
Suwanee, GA 30024-1265 - Phone
- (770) 888-5221
- Fax
- (770) 623-5544
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 | OT001466 | GA | Primary |
Addresses
Primary practice location
3905 Johns Creek CT
Suite 250
Suwanee, GA 30024-1265
Mailing address
3905 Johns Creek CT
Suite 250
Suwanee, GA 30024-1265
Phone (770) 888-5221
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT001466 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Creek Therapy | Occupational Therapist | Past | Accepting new patients |
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": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659462612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3905 JOHNS CREEK CT",
"address_2": "SUITE 250",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241265",
"telephone_number": "770-888-5221",
"fax_number": "770-623-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 JOHNS CREEK CT",
"address_2": "SUITE 250",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241265",
"telephone_number": "770-888-5221",
"fax_number": "770-623-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIATKOWSKI",
"first_name": "MARY",
"credential": "OTR,L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT001466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.