Edward Thomas Roe Jr., OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT005565 Issued in GA

Practice address

110 Woodfield Dr
Macon, GA 31210-5625

Phone

(478) 475-7988

Fax

(478) 475-7974

NPI assigned

Nov 9, 2012

Sex

Male

Sole proprietor

No

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.

• Sai Rehab Inc

  • Physical Therapist
  • Macon, GA
  • NPI 1104004431

  Occupational Therapist

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2012.

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1669726873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WOODFIELD DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "478-475-7988",
            "fax_number": "478-475-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WOODFIELD DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105625",
            "telephone_number": "478-475-7988",
            "fax_number": "478-475-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Eric Roddenberry, M.D.
• Robert Paul Roddenberry, M.D.
• Matthew Dale Rodgers
• Melissa Ivette Rodriguez, MM
• Misael Rodriguez, M.D.
• Danna Leigh Rogers, CSFA
• Gunnar Preston Rogers
• Haley Rogers, RBT
• John Kitchener Rogers, CRNA
• Penny Leigh Rogers, ACNPC-AG

• All providers in Macon, GA
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.