Payton Malone, OTR/L

Individual provider Active NPI Occupational Therapist · Fountain Inn, SC

NPI 1730779455 · NPPES record last updated Jan 26, 2021

Key facts

NPI
1730779455
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
6080 (SC)
Practice address
204 Shady Pines CT
Fountain Inn, SC 29644-9785
Phone
(864) 399-2674
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6080SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heaton Pediatric Therapy Inc. Occupational Therapist Past
since Jan 31, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6080 SC Yes

Addresses

Primary practice location

204 Shady Pines CT
Fountain Inn, SC 29644-9785

Mailing address

PO Box 1312
Fountain Inn, SC 29644-1054
Phone (864) 408-9509

Other providers in Fountain Inn, SC

All providers in Fountain Inn, SC · Occupational Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.