Individual provider Active NPI

Katelyn Elizabeth Hankinson Clamp, OTR/L

  • Occupational Therapist
  • Evans, GA
National Provider Identifier
1669218954
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT009211 Issued in GA
Practice address
536 Grand Slam Dr Ste D
Evans, GA 30809-8045
Phone
(706) 842-3330
Fax
(706) 854-8435
NPI assigned
Jul 5, 2024
Last updated
Jul 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT009211 GA Primary

Addresses

Primary practice location

536 Grand Slam Dr Ste D
Evans, GA 30809-8045

Mailing address

536 Grand Slam Dr Ste D
Evans, GA 30809-8045
Phone (706) 842-3330

Other practice location 1

5176 Wrightsboro Rd
Grovetown, GA 30813-2802
Phone (706) 842-3330

Other names 1

  • Katie Clamp Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250221000912 GA Practitioner - Occupational Therapist in Private Practice 1052831906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Trails of Evans CurrentSince Jul 7, 2024 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 15, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

536 Grand Slam Dr
Ste D
Evans, GA 30809
Phone (706) 842-3330

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1669218954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE D",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-842-3330",
            "fax_number": "706-854-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE D",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-842-3330",
            "fax_number": "706-854-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5176 Wrightsboro Rd",
            "address_purpose": "LOCATION",
            "city": "Grovetown",
            "state": "GA",
            "postal_code": "308132802",
            "country_code": "US",
            "telephone_number": "706-842-3330",
            "fax_number": "706-426-1168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAMP",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH HANKINSON",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT009211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "CLAMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.