Active NPI
Walt Collins
- Occupational Therapist
- Baxley, GA
National Provider Identifier
1699398073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT006364
- Practice address
- 118 Azalea Rd Ste 11
Baxley, GA 31513-9197 - Phone
- (912) 705-2855
- NPI assigned
- May 20, 2020
- Last updated
- May 20, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT006364 | GA | Primary |
Addresses
Primary practice location
118 Azalea Rd Ste 11
Baxley, GA 31513-9197
Mailing address
118 Azalea Rd Ste 11
Baxley, GA 31513-9197
Phone (912) 705-2855
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1699398073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 AZALEA RD STE 11",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315139197",
"telephone_number": "912-705-2855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 AZALEA RD STE 11",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315139197",
"telephone_number": "912-705-2855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "WALT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-20",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT006364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxley, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.