Active NPI
Elizabeth Rose, OTR
- Pediatric Occupational Therapist
- Marietta, GA
National Provider Identifier
1679608657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT001074
- Practice address
- 3565 Austell Rd SW
Suite 11
Marietta, GA 30008-5769 - Phone
- (770) 319-8000
- Fax
- (770) 319-8730
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT001074 | GA | Primary |
Addresses
Primary practice location
3565 Austell Rd SW
Suite 11
Marietta, GA 30008-5769
Mailing address
3565 Austell Rd SW
Suite 11
Marietta, GA 30008-5769
Phone (770) 319-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magnolia Rehab Services | Pediatrics | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1679608657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3565 AUSTELL RD SW",
"address_2": "SUITE 11",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300085769",
"telephone_number": "770-319-8000",
"fax_number": "770-319-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3565 AUSTELL RD SW",
"address_2": "SUITE 11",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300085769",
"telephone_number": "770-319-8000",
"fax_number": "770-319-8730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ELIZABETH",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "OT001074",
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.