Individual provider Active NPI

Amanda Odegaard, OTR/L

  • Occupational Therapist
  • Marietta, GA
National Provider Identifier
1679104384
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT009673 Issued in GA
Practice address
300 Tower Rd NE Ste 100
Marietta, GA 30060-9403
Phone
(770) 499-9918
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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 OT009673 GA Primary

Addresses

Primary practice location

300 Tower Rd NE Ste 100
Marietta, GA 30060-9403

Mailing address

4000 View Dr Unit 4306
Woodstock, GA 30189-5526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251118002896 GA Practitioner - Occupational Therapist in Private Practice 7416448337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Orthopaedics and Sports Medicine Specialists LLCGroup PAC ID 6204723216, 48 clinicians

Practice addresses (Care Compare)

100 Greystone Power Blvd
Dallas, GA 30157-0908
Phone (678) 453-5717

1505 Stone Bridge Pkwy
Suite 200
Woodstock, GA 30189-8255

300 Tower Rd
Suite 200
Marietta, GA 30060-9403

300 Tower Rd NE
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

720 Transit Ave
Suite 202
Canton, GA 30114-2544
Phone (770) 345-5717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT009673GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC Occupational Therapist CurrentSince Sep 22, 2025 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Sep 22, 2025 Accepting new patients

Locations

300 Tower Rd NE
Ste 100
Marietta, GA 30060
Phone (770) 499-9118

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

Organizations & group practices 2

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1679104384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 VIEW DR UNIT 4306",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-499-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEGAARD",
        "first_name": "AMANDA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT009673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.