Magnolia Pediatric Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT1767 Issued in MS

Legal business name

MAGNOLIA PEDIATRIC THERAPY, LLC

Practice address

239 Clark Farms Rd
Madison, MS 39110-8115

Phone

(601) 519-8930

NPI assigned

Mar 7, 2018

Organization subpart

No

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

Authorized official

Name

Jamie Austin, OTR/LNPI 1023259322

Title

Occupational Therapist

Phone

(601) 519-8930

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie M Austin, OTR/L

  • Occupational Therapist
  • Jackson, MS
  • NPI 1023259322
  NPD (past) Authorized official

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1689176323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CLARK FARMS RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108115",
            "telephone_number": "601-519-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CLARK FARMS RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108115",
            "telephone_number": "601-519-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "601-519-8930",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Pediatric Dental Group, PLLC
• Madison Professional Eyecare Associates, Inc
• Madison Radiological Group LLC
• Madison Spine Surgery Center, LLC
• Madison Surgicare Center, PLLC
• Mary Majette, M.S., CCC-SLP
• John Michael Manning Jr., M.D.
• Anna M Marshall, LCSW
• Kaitlyn Danielle Martin, OTR/L
• Martina Martin, LMSW

• Occupational Therapist in Madison, MS
• Providers in Madison, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.