Individual provider Active NPI

Alisha Chan

  • Occupational Therapist
  • Augusta, GA
National Provider Identifier
1699370502
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007903 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-2903
Phone
(706) 721-5222
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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 6011 SC
Occupational Therapist 225X00000X OT007903 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-2903

Mailing address

1120 15TH St # Or-6000
Augusta, GA 30912-0004
Phone (706) 721-8623

Other practice location 1

800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422

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

State licenses

LicenseStateTypeSpecialty
6011SCMDPhysical Therapist
OT007903GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1699370502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # OR-6000",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122903",
            "telephone_number": "706-721-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290722903",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ALISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6011",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.