Individual provider Active NPI

Anna Porter Goble, MSOT/RL

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1679819205
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT005543 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2208
Phone
(404) 686-1391
NPI assigned
Jan 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005543 GA Primary
Occupational Therapist 225X00000X 09-0165 NV

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2208

Mailing address

14 Anastasia Dr SE
Mableton, GA 30126-1461
Phone (702) 481-0072

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT005543GAMDOccupational Therapist
09-0165NVMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1679819205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ANASTASIA DR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261461",
            "telephone_number": "702-481-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "ANNA",
        "middle_name": "PORTER",
        "credential": "MSOT/RL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-01",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005543",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "09-0165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.