Jacqueline A Groce, OTR
Individual provider Active NPI Occupational Therapist · Stone Mountain, GA
NPI 1669595708 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669595708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT003908 (GA)
- Practice address
- 2155 W Park CT
Suite G
Stone Mountain, GA 30087-3500 - Phone
- (770) 465-5084
- Fax
- (770) 465-5304
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Transperfect Health Corp
Practice addresses (Care Compare)
1170 Peachtree St NE
Suite 1600
Atlanta, GA 30309-7674
Phone (570) 854-1632
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190909002035 | GA | Practitioner - Occupational Therapist in Private Practice | 8921337403 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12964 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Rehabilitation Georgia, LLC | Occupational Therapist | Current |
Accepting new patients |
| Transperfect Health Corp | Occupational Therapist | Current |
Accepting new patients |
| Select Rehabilitation, LLC | Occupational Therapist | Current |
Accepting new patients |
| Sierra Therapy Services, Inc. | Past | Accepting new patients |
Locations
762 N Main St
Alpharetta, GA 30009
Phone (678) 268-6335
1170 Peachtree St NE
Ste 1600
Atlanta, GA 30309
Phone (570) 854-1632
125 Riverstone Ter
Canton, GA 30114
Phone (770) 479-0472
1479 Grove Park Dr
Columbus, GA 31904
Phone (706) 222-7188
815 Atlanta Hwy
Cumming, GA 30040
Phone (678) 208-2418
7955 Majors Rd
Cumming, GA 30041
Phone (678) 648-5239
5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540
5373 Thompson Mill Rd
Hoschton, GA 30548
Phone (678) 358-6200
5050 Kimball Bridge Rd
Johns Creek, GA 30005
Phone (678) 395-4202
2450 Buford Dr
Lawrenceville, GA 30043
Phone (470) 712-5883
166 Oakland Pkwy
Leesburg, GA 31763
Phone (229) 232-8520
550 Barrington Dr
Roswell, GA 30075
Phone (678) 436-8672
4580 Towne Lake Pkwy
Woodstock, GA 30189
Phone (678) 771-6459
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
1250 Broadway
Fl 32
New York, NY 10001
Phone (212) 290-6447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT003908 | GA | Yes |
Addresses
Primary practice location
2155 W Park CT
Suite G
Stone Mountain, GA 30087-3500
Mailing address
1528 Breton Hunt LN
Suwanee, GA 30024-3874
Phone (678) 482-6040
Other providers in Stone Mountain, GA
- Greenridge Community Integration Home
- Natasha C Gresham
- Lashawnda M Grier
- Torri L Griffin
- Michele Y Griffith
- Xiaoying Gu
- Guardian Angels HHS
- Guided Grace Companions, LLC
- Derrick Guinn
- Gwendolyn Gunther
All providers in Stone Mountain, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.