Mary Elizabeth Pennington, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT008255 Issued in GA

Practice address

3843 Ivy CT
Martinez, GA 30907-2812

Phone

(706) 750-3282

NPI assigned

Jan 6, 2025

Last updated

Jan 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Swallowing Diagnostics

  • Health Service Clinic/Center
  • Ooltewah, TN
  • NPI 1205377348

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1689483588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 IVY CT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072812",
            "telephone_number": "706-750-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3843 IVY CT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072812",
            "telephone_number": "706-750-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ewa Halina Paziak, PSY.D.
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• Susan M Pencille, P.T.
• Jennifer Jocelyn Peters, RDN
• Marlene Frances Petta, MSSA ACSW LMSW
• Pharmacotherapy Center
• Genette Mary Phelps, MHS
• Sandra Phillips, LPC

• Occupational Therapist in Martinez, GA
• Providers in Martinez, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.