NPIMap

Organization Active NPI

Earthshine Therapy LLC

  • Occupational Therapist
  • Cartersville, GA
National Provider Identifier
1720526650
Registry record updated Feb 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004855 Issued in GA
Legal business name
EARTHSHINE THERAPY LLC
Practice address
29 Topridge Dr
Cartersville, GA 30120-6188
Phone
(770) 546-5184
NPI assigned
Feb 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2017

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

Authorized official

Name
Amanda Leah MirandyNPI 1790222305
Title
Owner
Phone
(770) 546-5184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X OT004855 GA Primary

Addresses

Primary practice location

29 Topridge Dr
Cartersville, GA 30120-6188

Mailing address

29 Topridge Dr
Cartersville, GA 30120-6188

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1486771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486771200000",
    "number": "1720526650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TOPRIDGE DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301206188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 TOPRIDGE DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301206188",
            "telephone_number": "770-546-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTHSHINE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-11",
        "last_updated": "2017-02-11",
        "status": "A",
        "authorized_official_last_name": "MIRANDY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "LEAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-546-5184"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; 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.