Courtney Kinnison, OTR/L

Key facts

NPI

1669935839

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

OT007310 (GA)

Practice address

5000 Research CT Ste 450
Suwanee, GA 30024-6660

Phone

(770) 205-5551

NPI assigned

Apr 12, 2019

Sex

Female

Sole proprietor

No

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.

• Kidztherapy Networks Inc Pediatric Occupational Therapist · Cumming, GA · NPI 1700913522
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 12, 2019.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1669935839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VENUE WAY APT 2306",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054533",
            "telephone_number": "985-507-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 RESEARCH CT STE 450",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246660",
            "telephone_number": "770-205-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNISON",
        "first_name": "COURTNEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Suwanee, GA · Occupational Therapist in Georgia